The OMB found that Medicare improperly spent $24 billion for fee for service in FY 2009, which translates to a rate of 7.8 percent of total outlays, compared with 3.6 percent in FY 2008. Medicaid improperly spent $18 billion, at a rate of 9.6 percent, and Medicare Advantage improperly spent $12 billion, at a rate of 15.4 percent, according to the report.
The increase in improper payments could be due in part to more rigorous methods of calculating errors, in line with the Obama administration’s dedication to reducing fraud and waste within the system, according to the report.
Payments are also labeled as improper if it is determined they are medically unnecessary or they lack proper documentation from healthcare providers. Centers for Medicare and Medicaid Services said it is taking further steps to ensure physicians and providers submit all medical documents necessary to process a claim, according to the report.
Read the AMNews report about the $54 million in improper CMS payments.
