GAO: Medicare spent $48 billion on improper fee-for-service payments

Share this article:

The federal government spent nearly $48 billion on improper Medicare payments in 2010 according to a new report from the Government Accountability Office. The report was released just prior to a House Oversight Committee hearing on government efficiency.

Medicare's large size makes it ripe for unsavory billing practices, federal watchdogs noted in the report. Still, the total amount of money wasted on improper payments exceeds spending on any government program. Investigators found that the $48 billion is attributable to Medicare fee-for-service programs, which include Part A and Part B. Part A covers skilled nursing facility and hospital stays, while Part B covers hospital outpatient, rehabilitation, physician and other services. The improper payment rate for Medicare Advantage — the program with which recipients receive benefits through private plans — was even higher than Part A and B, at 14.1%.

During the hearing, officials from the Department of Health and Human Services touted the agency's efforts to lower improper fee-for-service payment rates. The agency lowered error rates for fee-for-service billing for physicians and hospitals from 12.4% in 2009 to 10.5% in 2010, according to the report.

Share this article:

More in News

CMS updates coding instructions for hospice site of service, principal diagnosis

CMS updates coding instructions for hospice site of ...

A new Medicare hospice manual update includes instructions for which principal diagnosis codes are acceptable, and clarifies which codes should be used for services in a skilled versus non-skilled nursing ...

Vast majority of nursing home residents chronically constipated, and it's not well ...

Chronic constipation is highly prevalent in nursing homes and not well controlled, leading to a high likelihood that residents develop fecal impaction, according to findings from a first-of-its kind study.

Federal judge dismisses nursing home 'kickback' case; upholds large X-ray company's 'swapping' ...

The way mobile x-ray company Mobilex bills nursing homes is acceptable, a federal judge recently determined. Mobilex is the nation's largest provider of mobile diagnostic services. It had been facing whistleblower charges that it effectively paid kickbacks to nursing homes through an arrangement known as ...