Er­ror rates down

Medi­care im­proper pay­ment num­bers im­prove

Modern Healthcare - - The Week In Healthcare - Jes­sica Zig­mond

Im­proper pay­ments to the Medi­care pro­gram to­taled about $34.3 bil­lion in 2010, ac­cord­ing to the CMS. That fig­ure is an im­prove­ment from last year, the agency said, as the Medi­care feefor-ser­vice er­ror rate dropped to 10.5% in 2010, com­pared with a rate of 12.4%— to­tal­ing $35.4 bil­lion in im­proper pay­ments to Medi­care—in 2009.

For Medi­care Ad­van­tage plans, or Medi­care Part C, the er­ror rate dropped to 14.1% in 2010 for a to­tal of $13.6 bil­lion in im­proper pay­ments, com­pared with an er­ror rate of 15.4% and a to­tal of $12 bil­lion in 2009. Those were de­ter­mined based on the 2008 pay­ment rate ac­cord­ing to the CMS. In the Med­i­caid pro­gram, only one-third of states are re­viewed each year for er­ror rates, so the agency re­leased a three-year av­er­age rate of 9.4% for a to­tal of $22.5 bil­lion in im­proper pay­ments, which re­flects an av­er­age of the rates in 2008, 2009 and 2010, which were, re­spec­tively, 10.5%, 8.7% and 9.0%.

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