Fraud, Payment Errors Continue to Trouble Federal Health Programs

摘要

When politicians and policy makers need to reduce government spending for health care, there is probably no more popular target that waste, fraud, and abuse. It's a safe target: there is no vocal constituency in support of committing fraud, abusing health laws and regulations, or overtly wasting scarce state or federal resources to provide health care for vulnerable populations. It's also an obvious target. The Government Accountability Office (GAO) recently told a House Oversight and Government Reform subcommittee that Medicare made an estimated Dollars 48 billion in improper payments in fiscal year 2010-not all fraudulent, but money that shouldn't have been paid. Of that amount, more than dollar34 billion can be attributed to Medicare fee-for-service (FFS) payments. The "Comprehensive Error Rate Testing" process used by the Centers for Medicare and Medicaid Services (CMS) to determine improper payment rates found that the error rate for fiscal year 2010 was 10.5% percent-numbers that get the attention of congressional committees.