Feds To Curb Improper Payments To Medicare Plans

The Obama administration says it's taking steps to fix a longstanding problem of improper payments to private health plans that serve 1 in 4 Medicare beneficiaries.

So-called Medicare Advantage plans face tighter audits under a policy issued Friday. The rules say Medicare must pay the plans a higher rate to care for sicker beneficiaries. But previous government audits discovered many claims were not backed up by proper medical documentation.

Medicare deputy administrator Jon Blum says he doesn't call it fraud, but it is a problem. The estimated error rate of 11 percent added up to $12 billion in improper payments last year.

The Obama administration says it wants to gradually reduce erroneous payments while maintaining quality. Medicare expects to save $370 million beginning this year, and more over time.

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  • by Medical Staff on Feb 26, 2012 at 01:08 PM
    So if you were having a heart attack and you were given 4 81mg Aspirin, would it not be worth $120? The reason due to price inflation is because of people that don't have the drive to get a descent job with health insurance and rely on federal benefit. Do you really think that Medicare/Medicaid/private health insurance pays $30/ aspirin? Inflation is used to cover what they won't pay and what self-payers don't pay.......
  • by Anonymous on Feb 25, 2012 at 04:20 PM
    Sounds like I keep hearing something like this almost every year about them cracking down on improper medicare payments in one form or another. I just wonder when they will stop talking about it and start doing it.
  • by Lee Washington on Feb 25, 2012 at 04:15 PM
    When a person or company recieves 12 billion dollars of money from the government that they don't deserve weather from improper paperwork or not it is stealing. The reason it is not a crime is because it is doctors, hospitals, and long term care facilities. that steal the most and they own the government like big oil companies. They need to give it back and if they don't what is it called then. They sleal enough from the taxpayer in the form of overinflated prices, like $30.00 asprin.

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