HomeMedicare Dispatch → CMS Announces New TPE Audit Program

CMS Announces New TPE Audit Program Print E-mail
Written by Sharon Parsley | Florida Healthcare Law Firm   
Tuesday, 26 September 2017 19:05

The Centers for Medicare & Medicaid Services (CMS) relies on its Medicare Administrative Contractors (MACs) to serve as guardians of the Medicare trust fund through the MACs taking steps to prevent improper payments.  Despite that reliance, in its most recent report to the U.S. Senate Finance Committee, the Government Accountability Organization(GAO) reports that improper payments totaling $41.1 billion (no, that is NOT a typo, that is a "b") occurred during 2016 in the Medicare fee-for-service program. That figure represents an overall 11% percent improper payment rate.
How many of us would feel good about being "wrong" in our core job function 11% of the time? Not very many of us, I suspect.
The GAO report goes on to quote the MACs as generally having ongoing concerns about the following types of claims as those which pose the greatest financial risk to the Medicare trust fund.
Last Updated on Tuesday, 26 September 2017 19:07

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