Tag: Improper payments

WASHINGTON – The Office of Inspector General has published its annual “Top Unimplemented Recommendations: Solutions to Reduce Fraud, Waste and Abuse in HHS Programs” and DME makes more than one appearance.  This year, the OIG’s recommendations focus on the top 25 unimplemented recommendations that, in its view, would most positively affect HHS programs in terms of cost savings, program effectiveness and efficiency, and public health and safety if implemented.  Recommendations...

WASHINGTON - CMS announced Nov. 18 that program integrity measures lowered the estimated amount of Medicare fee-for-service improper payments by $7 billion from FY 2017-19 to $28.9 billion, the lowest level since FY 2010.Specifically, the agency says DMEPOS improper payments decreased an estimated $1.29 billion from FY 2016-19 due to various corrective actions.“Our progress on improper payments is historic, but there's more work to be done,” said CMS Administrator Seema Verma. “CMS...

WASHINGTON - Medicare improperly paid suppliers $34 million for DME and supplies that were provided during inpatient stays, according to a new report from the Office of Inspector General.Those items should have been provided directly by the inpatient facility or under arrangements between the facility and the supplier, according to the report.In addition, beneficiaries were improperly held responsible for deductibles and coinsurance provided during inpatient stays totaling $8.7 million.Medicare overpaid...

WASHINGTON - The improper payment rate for DMEPOS decreased from 46.2% in 2016 to 35.5% in 2018, representing a decrease of $1.14 billion, according to a bulletin from AAHomecare. The improper payment rate for all Medicare fee-for-service decreased from 9.5% in 2017 to 8.1% in 2018. The association met with CMS's Comprehensive Error Rate Testing team in June to explore ways to continue to improve error rates.

WASHINGTON - Medicare paid $23 million in improper payments on behalf of deceased beneficiaries in 2011, according to an Oct. 31 report from the Office of Inspector General (OIG).Those payments account for less than one tenth of a percent of total Medicare spending, the report says.The OIG says auditors identified beneficiaries who died between 2009 and 2011, then found payments associated with those beneficiaries paid in 2011. It also found paid and unpaid Medicare Part B claims dated after beneficiaries...

WASHINGTON - The improper payment rate for DMEPOS in 2012 was a whopping 66%, according to a new report released by CMS. Of the $9.7 billion Medicare paid for DMEPOS in 2012, $6.4 billion was improper, the report states. Across Medicare, the improper payment rate was 8.5%, representing $29.6 billion. That means DMEPOS, which represents about 2.8% of all Medicare fee-for-service expenditures, accounted for 19.8% of the overall improper payment rate, the report states. The vast majority of improper...

WASHINGTON - A new report from the Office of Inspector General (OIG) says that while CMS took corrective actions to address the majority of the vulnerabilities it identified, the agency did not evaluate the effectiveness of these actions.“As a result, high amounts of improper payments may continue,” the report states.The OIG found that, of 2.6 million claims reviewed in 2010 and 2011, the RACs identified 1.3 million as having improper payments—at a cost of $1.3 billion.During those...