CMS touts prevention efforts

Wednesday, July 20, 2016

WASHINGTON – CMS’s efforts to reduce improper payments have saved nearly $42 billion, according to a new report.

The savings, from Oct. 1, 2012, to Sept. 30, 2014, equate to an average savings of $12.40 for every dollar spent, according to a new report form the Center for Program Integrity.

The CPI’s efforts include making sure enrolled healthcare providers are properly screened; using predictive analytics to prevent fraud, waste and abuse; and coordinating anti-fraud efforts with federal and external partners, including state Medicaid and agencies and law enforcement agencies.

“CMS’s efforts to proactively prevent potentially fraudulent and improper payments from being made have been increasingly effective, moving our efforts away from the ‘pay-and-chase’ method of recovering payments after they had already been made,” the agency stated in a press release.

In fiscal year 2013, savings from prevention activities represented 68% of total savings; that rose to nearly 74% in fiscal year 2014.

“CMS is dedicated to promoting better care, protecting patient safety, reducing healthcare costs, and providing people with access to the right care, when and where they need it,” the agency stated. “This includes continually strengthening and improving Medicare and Medicaid programs that provide vital services to millions of Americans.”  

CMS will release fiscal year 2015 numbers later this year.