Improper Medicare Payments Skyrocketed in 2013, According to Senate Report

This week, the Senate Committee on Aging released a disturbing Bipartisan Report revealing that the rate of improper Medicare payments has mushroomed over the past twelve months. According to the Report, Medicare fee-for-service’s improper payment rate increased from percent in FY 2012 to 10.1 percent in FY 2013. The Report stressed, “The 10.1 percent improper payment rate in Medicare fee-for-service programs represented a dramatic increase in improper payments, compared to the previous five years.”

The Report spotlighted some of the most egregious problem areas. For their Medicare Part A claims, home health led the race to the bottom, with over 17% of claims considered improper. For Medicare Part B claims, Oxygen Equipment and Glucose Monitoring, providers improperly submitted claims to Medicare a whopping 75% of the time!

Hospitals were not walking a straight line either, however. According to the Report, initial hospital visits were improperly billed to Medicare Part B 28.3% of the time, and subsequent visits were billed improperly 18.2%. Inpatient hospital MS-DRG claims were reported as improperly submitted to Part A on regular basis, resulting in $11.64 billion in improper payments.

“Clearly, Medicare fraud is metastasizing at a time when a large percentage of the population is aging into Medicare,” explained Nolan, Auerbach & White partner Marcella Auerbach. “To combat this trend, the Justice Department should continue moving forward with False Claims Act qui tam actions that recover our nation’s stolen Medicare dollars.”

More information for whistleblowers is located at the Nolan Auerbach & White website.