Federal Efforts To Curb Health Program Fraud Saved $17.6B Last Year
On Tuesday, the Obama administration announced that its efforts to reduce improper payments by federal programs, including Medicare and Medicaid, have saved $17.6 billion in the last year, The Hill's "Healthwatch" reports.
The effort, called the "Campaign to Cut Waste," is part of an executive order issued by President Obama to prevent improper payments by Medicare, Medicaid, Pell Grants and food stamp programs.
Administration officials said the initiative is on pace to reach its goal of preventing $50 billion in payment errors by the end of 2012 (Pecquet, "Healthwatch," The Hill, 11/15).
Reduction in Payment Error Rates
Data indicate that such waste reduction measures have resulted in Medicare's payment error rates falling from 10.2% in 2010 to 8.6% in 2011. In addition, Medicare's fee-for-service error rate declined from 9.1% in 2010 to 8.6%, while Medicare Part D's 2011 error rate of 3.2% was well below the government average.
Further, Medicaid's payment error rate declined from 9.4% in 2010 to 8.1% in 2011, which resulted in the program avoiding about $4 billion in improper payments.
HHS Pilot Programs To Further Address Improper Medicare, Medicaid Payments
HHS Secretary Kathleen Sebelius on Tuesday announced four pilot programs intended to further reduce Medicare and Medicaid error rates, waste and fraud (Daly, Modern Healthcare, 11/15). The programs will:
- Expand use of Recovery Audit Contractors to screen certain hospital payments before they are made to catch wasteful spending;
- Allow hospitals to resubmit bills to Medicaid for certain services when they make an error;
- Permit HHS to review certain medical equipment claims before they are made; and
- Test an automated tool to screen health providers for fraud risk through a partnership with states.
Sebelius said, "Today we have shown real progress in cutting waste, fraud and abuse, but we still need Congress to act on the President's proposal," adding, "Until Congress acts, we will continue doing everything in our power to save money on behalf of the American people" ("Healthwatch," The Hill, 11/15).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.