Report Cites Errors in Medicare Claim Payments

A review of Medicare claims for medical and prosthetic equipment in 2006 found that improper or erroneous payments were almost four times more common than the federal government estimated.

The report on the Medicare claims error rate, released on August 22, found a 28.9 percent error rate in the review of paid Medicare claims for medical equipment, prosthetics, and orthotics in 2006, as opposed to the 7.5 percent rate reported by the Centers for Medicare & Medicaid Services. The report was issued by U.S. Department of Health and Human Services Inspector General Daniel Levinson, and is titled Medical Review of Claims for the Fiscal Year 2006 Comprehensive Error Rate Testing Program. The Washington Post reports that the improper Medicare payments discovered in the audit "include not only fraudulent claims, but also those without sufficient documentation and those for goods deemed not medically necessary."

According to the Miami Herald, the HHS Inspector General's report was issued a few weeks after the newspaper published a series on corruption in regional medical equipment suppliers and HIV drug clinics, which "underscored Medicare's failure to root out fraudulent claims submitted to the health insurance program."

• Read the Report: Medical Review of Claims for the Fiscal Year 2006 Comprehensive Error Rate Testing Program [PDF file]
• Washington Post: Report Faults Medicare Audits
• Miami Herald: Inspector General Chastises Medicare on Waste
• Miami Herald: Chart: Lost Money and Medicare Fraud Prosecutions
• Medicare.gov - Official U.S. Government Site for People with Medicare
• Medicare FAQ (FindLaw)
• Health Care Options: Medicare and Medicaid (FindLaw)