A Medicare change meant to lower beneficiaries' copayments for hospital outpatient services will have resulted in an estimated $414 million in inaccurate payments by the CMS in fiscal 2003, largely undercharges, according to a General Accounting Office report. Medicare will have overcharged outpatient beneficiaries $111 million for certain services and undercharged them $303 million for others because of a new copayment formula, the GAO said. The report recommends that the CMS revise its 2003 figures based on the previous formula and use the revised numbers to calculate 2004 copayments. The Balanced Budget Act of 1997 mandated that the CMS incrementally reduce beneficiary cost-sharing for hospital outpatient services to no more than 20% of cost. In comments responding to a draft of the GAO report, the CMS said it would take the findings into consideration when issuing a final 2004 outpatient payment rule, which is expected by the end of this month. Read the GAO report. -- by Jeff Tieman
Medicare got bad deal in new copayments: GAO
Send us a letter
Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.
Recommended for You