The CMS saved about $42 billion in fiscal years 2013 and 2014 through program integrity efforts, according to a report to Congress released Wednesday.
The CMS attributed the savings to increased provider enrollment and screening standards as well as fraud prevention efforts established by the Affordable Care Act.
Dr. Shantanu Agrawal, deputy administrator and director of the CMS Center for Public Integrity, said in a blog post that the savings amounted to $12.40 for every dollar invested in program integrity. That money can be reinvested into the program and be used to provide healthcare for beneficiaries of Medicare, Medicaid and the Children's Health Insurance Program.
“CMS is dedicated to promoting better care, protecting patient safety, reducing health care costs, and providing people with access to the right care, when and where they need it,” he said. “This includes continually strengthening and improving Medicare and Medicaid programs that provide vital services to millions of Americans. We take our responsibility to deliver better care at a better value seriously.”
Fraud prevention efforts accounted for about 68% of the savings in fiscal 2013 and nearly 74% in fiscal 2014. A July 2015 report found that fraud prevention had identified or prevented $820 million in inappropriate payments since it was implemented in June 2011.