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 fee-for-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.
Medicare payment error rate edges down
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%. The CMS also said it will report a composite error rate for Medicare Part D in 2011.
The CMS said that although improper payment rates are “not necessarily an indicator of fraud,” they do provide HHS, the CMS and states with a better assessment of how many errors need to be fixed.
“Over the past year we have improved the processes we used to review Medicare and Medicaid payments in an effort to identify if there are specific issues that need to be addressed,” CMS Administrator Donald Berwick, M.D., said in a news release. “The president has directed HHS and CMS to cut the fee-for-service error rate in half by 2012. This is a priority for CMS and we are on our way toward achieving it.”
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