HHS Using Tougher Standards to Calculate Improper Medicare Payment Rates for 2009

As part of the Obama Administration’s goal of reducing waste, fraud and abuse in Medicare, the HHS and CMS significantly revised and improved its calculations of Medicare fee-for-service (FFS) error rates in 2009. “As we move forward in our review of the Medicare and Medicaid error rate data, we expect to be able to determine if there are specific trends that can better help us identify weaknesses in our programs or systems,” said Acting CMS Administrator Charlene Frizzera. “We hope to be able to use data available through the use of new electronic health record reporting that can help in the design of new and innovative approaches to finding emerging trends and vulnerabilities in high risk areas such as durable medical equipment and home health.” HHS Secretary Kathleen Sebelius and Frizzera also pointed out the HHS and the CMS would invest more time and resources into working with providers to eliminate errors through increased and improved training and education outreach. “It’s important that we continue to work closely with doctors, hospitals and other health care providers to make sure they understand and follow the more comprehensive fee-for-service requirements,” said Frizzera. “We are committed to working closely with them to reduce the rate of improper payments.”