Inspector General Levinson testifies about the HHS Office of Inspector General’s (OIG) efforts to monitor and make recommendations to reduce Medicare improper payments last week. He describes the scope of the problem, OIG’s oversight of the Department’s measurement of Medicare improper payments, and OIG’s role in preventing, detecting, and reducing improper payments.
Here are some excerpts from his 4-page testimony:
- In 2010, the Centers for Medicare & Medicaid Services (CMS) reported Medicare improper payments totaling $47.9 billion. Of that total, $34.3 billion is attributable to Medicare Fee-for-Service (10.5% error rate) and $13.6 billion is attributable to Medicare Part C (14%% error rate).
- Some but not all improper payments are the result of fraud. Improper payments can also result from medically unnecessary claims, miscoded claims, eligibility errors, or insufficient documentation. Examples of improper payments include payments made to an ineligible recipient, duplicate payments, or payment for services not received. For example, my office recently identified $3.6 million in improper Medicare Part D payments on behalf of deceased beneficiaries.
- Although not all improper payments are fraudulent, all payments resulting from fraud are improper. There is no precise measure of the magnitude of health care fraud, but we know that it is a serious problem that demands an aggressive response.
Read the full testimony (PDF) for more information.
Also, find the most recent OIG testimonies and speeches on the OIG website.