Reducing Improper Payment: A Collaborative Effort

(Source – CMS.gov)

On November 16, HHS released the annual Agency Financial Report, which includes an update on the improper payment rate for a variety of programs. The Medicare Fee-For-Service improper payment rate decreased from 12.7 percent in 2014 to 12.1 percent in 2015. The Two Midnight rule and corresponding educational efforts led to a reduction in improper inpatient hospitals claims, reducing the improper payment rate from 9.2 percent in 2014 to 6.2 percent in 2015. The improper payment rate for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) also decreased from 73.8 percent in 2010 to 40.1 percent as of September 2015. Corrective actions implemented over a six-year period, including the DMEPOS Accreditation Program, contractor visits to large supplier sites, competitive bidding, and a demonstration testing prior authorization of power mobility devices, contributed to the reduction in the improper payment rate for these items and supplies. Read more…

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