Wednesday, October 19, 2016

OIG: CMS Made $34.5 Million In Potentially Improper Medicare Payouts To The Incarcerated

$20 trillion in debt and 10 times that much in unfunded liabilities.

Government, when only the best will do.

Office of The Inspector General, Health and Human Services

From the OIG Report

CMS’s policies and procedures did not allow CMS to detect and recoup improper payments on a postpayment basis when CMS’s data systems did not identify a beneficiary as incarcerated at the time that a claim was processed. This nonidentification occurred because CMS turned off its postpayment claims edit. CMS has not taken steps Medicare Payments for Services Rendered to Incarcerated Beneficiaries (A-07-15-01158) iii to determine whether any of the $34,588,984 in potentially improper payments made in CYs 2013 and 2014 should have been denied. 

If you'd rather have the Cliff Notes version,

Fierce Health Payer Anti Fraud

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