improper payments Archives - Page 3 of 4

30 Jul COST AVOIDANCE TECHNOLOGY SOLUTIONS FOR MEDICAID

Posted at 13:51h in Medicaid

In addition to rising health care costs and increased spending from the program’s expansion, Medicaid is losing billions of dollars a year from improper payments. Protecting the integrity of the Medicaid program has become a top priority for the Centers for Medicare and Medicaid Services...

23 Jul MEDICAID COSTS PUT EMPHASIS ON RECOVERY EFFORTS

Posted at 09:38h in Medicaid

In 1965, Title XIX of the Social Security Act established the Medicaid program to provide health care coverage to low-income individuals. Over time it has developed into one of the nation's largest payers for health care, covering one out of five Americans. In FY 2017,...

28 Jun CMS AUDITS OVER MEDICAID IMPROPER PAYMENTS

Posted at 11:13h in Medicaid

Recent reports from the HHS OIG and the Louisiana Auditor General have indicated a high rate of Medicaid improper payments due to incorrectly determining Medicaid eligibility. The Senate Finance Committee wrote CMS on March 1st to inform the agency of their concerns over the...

27 May LEGISLATION FAILS TO REDUCE IMPROPER PAYMENTS IN GOVERNMENT-FUNDED PROGRAMS

Posted at 11:36h in Medicaid

Legislation such as the Improper Payments Information Act (IPIA P.L. 107-300) and Executive Order 13520 sought to address improper payments in government-funded programs. IPIA directed federal agencies to report on the number of improper payments occurring and outline what actions are being taken to reduce...

10 Apr REDUCING MEDICAID’S PRESCRIPTION DRUG COSTS

Posted at 14:15h in Medicaid

Since state Medicaid programs are responsible for the healthcare of several populations, skyrocketing prescription drug costs have become a major budgetary concern. Currently, health care spending is dominating many of their budgets and on a per capita basis, inflation-adjusted retail prescription drug spending has increased...

29 Mar SENATORS QUESTION OVERSIGHT OF IMPROPER PAYMENTS

Posted at 11:24h in Medicaid

Medicaid has been designated a high-risk program by the GAO since 2003 due to its size, growth, diversity and oversight challenges regarding improper payments, appropriate use of program dollars, and data. In fiscal year 2018, improper payments represented about 9.8% of the program's total spending...

18 Dec CMS ACHIEVES LOWEST IMPROPER PAYMENT RATE IN 10 YEARS

Posted at 13:55h in Medicaid, Third Party Liability

Medicare and Medicaid accounted for $40 billion dollars in improper payments last year and the Medicaid program has been on the GAO’s High Risk List since 2003 due to inadequate fiscal oversight. However, last month CMS announced that the agency achieved the lowest improper payment...

26 Oct PREVENTING IMPROPER MEDICAID PAYMENTS

Posted at 13:42h in Medicaid

Of the $4 trillion spent by the government in 2017, nearly $141 billion were improper payments. These are payments made in error either to the wrong recipient, in the incorrect amount, or for a service that is not legitimate. Fraud, antiquated data systems, and methodologies...

19 Sep GAO Criticizes Medi-Cal’s Outdated Reporting Model And Improved Medicaid Oversight

Posted at 11:05h in Medicaid

In August, the GAO submitted a report to Congress that focused on what CMS would need in order to better target risks and improve Medicaid oversight. The review determined that one of the critical problems the agency is facing is the failure to implement new...

07 Sep Government Officials And Agencies Work To Strengthen Medicaid’s Integrity

Posted at 13:16h in Medicaid

In 2017, improper payments within the Medicaid program reached a total of $37 billion, according to CMS. That equals 10 percent of the federal dollars spent on the program. Moreover, 99.2 percent of the payments made were overpayments. To make matters worse, under the current...

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