The Medicare, Medicaid and Children’s Health Insurance Program improper payment rates are issued annually as part of the HHS Agency Financial Report. While improper payment rates are not necessarily an indicator of fraud in Medicare or any other federal healthcare program, they do provide HHS, CMS and its partners who are responsible for the oversight of Medicare and Medicaid funds a more complete assessment of how many errors need to be fixed, according to the report.
“If we aren’t honest about the problem, there is no way we can get to a solution. Through a more stringent review of Medicare claims, we’ve been able to establish a more complete accounting of errors, enabling CMS to take more actionable steps to further reduce the error rate and identify abusive or potentially fraudulent actions before they become problems,” HHS Secretary Kathleen Sebelius said in the release. “This change in calculating the error rate is just one part of our larger Administration-wide effort to reduce waste, fraud and abuse in health care. In addition to the establishment of HEAT, the joint task force that was established earlier this year with the Department of Justice, we’ve taken aggressive steps at HHS and CMS to improve our oversight of the Medicare trust funds and the taxpayer dollars that pay for the health care of millions of older and vulnerable Americans.”
HHS also noted that the changes in the calculations and data available through electronic health records to help determine trends in errors in order to identify weakness in the system. HHS and CMS said in the release that they would invest more time and resources into working with providers to eliminate errors through increased and improved training and education outreach.
Read the release about HHS’s improvements to determining Medicare fee-for-service errors.
