Thursday, November 17, 2011

Feds Launch New Fraud Preventions To Save $17.6 Billion In 2011

Fierce Healthcare has;

November 16, 2011 — 12:12pm ET | By

The White House is making progress on its goals to curb fraud and error in federal programs such as Medicare and Medicaid, preventing $17.6 billion of wasteful payments in 2011, the Office of Management and Budget (OMB) announced yesterday.

Through ramped up fraud prevention, the Medicare fee-for-service error rate dropped from 9.1 percent in 2010 to 8.6 percent in 2011, while the overall error rate for Medicare programs fell from 10.2 percent in 2010 to 8.6 percent this year.

Thanks to the declining error rates, Medicare fee-for-service avoided $7 billion in payment errors and Medicare Part C saved almost $5 billion, the OMB notes.

Medicaid error rates dropped from 9.4 percent in 2010 to 8.1 percent in 2011, saving roughly $4 billion since 2009.

That success has prompted the Centers for Medicare & Medicaid Services (CMS) to launch four pilots to further reduce error rates and cut Medicare and Medicaid waste and fraud, the agency announced yesterday.

Under the pilots, CMS will expand the use of Recovery Audit Contractors, allowing private companies to review certain hospital payments before they are made, in the hopes of preventing wasteful spending before it happens. It also plans to examine changes to outdated hospital billing systems, enabling some claims that are wrongly made as inpatient services to be resubmitted as outpatient, CMS notes.

The agency also is establishing prior authorization for medical equipment claims with high error rates before they are made, as well as helping states weed out fraudsters with an automated tool that screens providers for risk of fraud.

For more information:
- read the OMB
press release
- here's the CMS
press release

Related Articles:
CMS struggles to monitor Medicare contractors due to inaccurate data
Medicare fraud suspensions not enforced
Feds triple recovered money from Medicaid scams
Congress urges CMS to fight Medicare fraud with moratoriums

Thank you Fierce Healthcare and Ms Caramenico

Great News, huh?

Now, Hows About our Healthcare Fraud "Cleanup On Aisle $17.6 Billion" Crew get themselves on over to CMS, ..... or Whoever's Responsible for it, ......and get this REVOCATION of the 1st Amendment called Dialectical Behavioral Therapy yanked OFF of America's Medicare & Medicaid reimbursement schedules?

Government Healthcare Programs are being BILLED by Quacks peddling Buddhism based on the Opinions of a self admitted Schizophrenic, Borderline Personality Disordered, (psychiatry's opinions, not our's) Hegelian Dialectician.

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