Medicare Payment Errors Nearly $20 Billion

[Rose Siding]

WASHINGTON -- The private companies that process health claims for Medicare made nearly $20 billion in erroneous or questionable payments last year, an error rate of 9.3 percent, the government said Monday. The performance was a slight improvement over last year.

The error rate measures claims that were paid despite being medically unnecessary, inadequately documented or improperly coded. In some instances, Medicare asked health care providers for medical records to back up their claims and got no response.

Medicare chief Mark McClellan said the survey does not document instances of alleged fraud.
...
The review found that doctors and other providers were paid $900 million less than they should have received because of errors made by insurers. By contrast, there were $20.8 billion in questionable overpayments, Medicare said.

http://www.newsday.com/news/politics/wire/sns-ap-medicare-accuracy,0,2989885.story?coll=sns-ap-politics-headlines

[kuozzman]

1. I watched this hearing the other night on CSPAN,

complete raping of consumers and obviously the government, which is again, the consumers' $$, by pharms/suppliers/insurers. They admitted quite a few shitty tactics they use. Mainly has to do with the AWP, which they went on to say, is completely pointless. Then at the end, I couldn't believe my fuckin eyes, main guy on the committee (foget who) ended by saying how horrible it was that the government made them use this AWP thing, that just caused confusion and even lawsuits, which he said they must be reimbursed for. I've been trying, a little, to find the docs relating to the hearing. I'm glad you made this post.