Medicare contractors are using inaccurate and inconsistent data that prevents them from detecting fraud, according to an OIG report detailed by the Associated Press.
The OIG report found consistent issues among fraud contractors over the last 10 years, as well as failure on the part of federal health officials to supervise the contractors' work. Investigators said health officials did not look at measures that would paint a more accurate picture of contractor performance, such as how many investigations were initiated by contractors.
Contractors also varied in the type of data they used. Because some contractors were found to use inaccurate data, health officials may have trouble determining which contractors are effective.
The same issues were reported 10 years ago by an OIG report, and multiple reports over the last 10 years have identified similar problems. Problems persist with the new system, despite CMS' claim that the latest system of fraud contractors was designed to fix issues noted with earlier contractors.
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The OIG report found consistent issues among fraud contractors over the last 10 years, as well as failure on the part of federal health officials to supervise the contractors' work. Investigators said health officials did not look at measures that would paint a more accurate picture of contractor performance, such as how many investigations were initiated by contractors.
Contractors also varied in the type of data they used. Because some contractors were found to use inaccurate data, health officials may have trouble determining which contractors are effective.
The same issues were reported 10 years ago by an OIG report, and multiple reports over the last 10 years have identified similar problems. Problems persist with the new system, despite CMS' claim that the latest system of fraud contractors was designed to fix issues noted with earlier contractors.
Related Articles on Coding, Billing and Collections:
Physicians Push for Changes to Proposed Health Insurance Exchange Rules
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7 Goals for ICD-10 Preparation for the Next Six Months