The Office of Inspector General submitted a testimony to the House of Representatives Subcommittee on Oversight and Investigations, in which the OIG implored CMS to do more to help stop ineligible providers from enrolling in Medicare, according to RevCycle Intelligence.
Here are five notes:
1. OIG is asking CMS to collaborate with the states to help collect sufficient data on ineligible providers.
2. When CMS fails to stop such providers form enrolling in Medicare, the agency puts itself at risk for fraud. Last year, Medicare and Medicaid paid nearly $88.8 billion in improper payments, according to HHS.
3. OIG also found, despite HHS' efforts to limit improper payments, the agency is not meeting the Improper Payments Elimination and Recovery Act of 2010's reporting requirements. HHS's Medicare fee-for-service error rate percentage surpassed 10 percent last year.
4. HHS also failed to meet its improper payment targets for Medicare Advantage, Medicaid, Children's Health Insurance Program and Child Care Development Fund. HHS's Medical Advantage program had a 9.5 percent improper payment rate and Medicaid had a 9.8 improper payment rate, surpassing HHS' target of 8.5 percent for MA and 6.7 percent for Medicaid.
5. To combat such payments, OIG advises CMS to:
• Implement enrollment safeguards
• Help state put tools in place to help navigate the Affordable Care Act
• Closely monitor contracts
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