Medicare reports drop in improper payments
The Health Care Financing Administration (HCFA) is touting the fact that improper Medicare payments to providers fell again last year, dropping to a 6.8% error rate in fiscal year 2000, down from nearly 8% the year before. These figures are based on the most recent financial audit of HCFA claim payments by the Office of the Inspector General (OIG). In FY 1996, Medicare’s reimbursement error rate was an estimated 14%. The target goal for FY 2002 is 5%.
According to the OIG, virtually all the sampled claims examined in the review were paid correctly by Medicare based on the information that was submitted in the claims. The errors were identified by medical review staff members who researched a sample of claims in patient medical records and found problems with:
- documentation used to back up the claims;
- coding of the services provided;
- medical need for the services;
- the fact that Medicare did not cover the services provided.
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