OIG: Regulators need to sharpen retrieval of Medicare overpayments made to providers

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OIG: Regulators need to sharpen retrieval of Medicare overpayments made to providers
OIG: Regulators need to sharpen retrieval of Medicare overpayments made to providers

Medicare recovery audit contractors have not been diligent enough in collecting previously identified overpayments, a government investigation finds.

Contractors working for the Centers for Medicare & Medicaid Services did not succeed in collecting $332 million of $418 million in Medicare payments identified in prior audits, according to a report from the Office of the Inspector General, an arm of the Department of Health and Human Services

“We could not verify the amounts that CMS had reported as collected because CMS did not (1) routinely require supporting documentation from the contractors to verify whether the contractors had actually collected the OIG-recommended overpayments or (2) validate the information it had received,” the report states.

In recent months, CMS has touted its aggressive recovery of Medicare overpayments as part of ongoing antifraud measures. Under the program, auditors review provider claims — such as those submitted by nursing homes and physicians — to assure provider compliance.

Click here to read the OIG report.