Improper Medicare payments down $20.7B since 2014, CMS data show

The number of improper payments made under Medicare fee-for-service declined by $20.72 billion since 2014, according to new figures from the Biden administration.

The Centers for Medicare & Medicaid Services (CMS) said the data, released Monday, are the result of “aggressive corrective actions” to root out the cause of improper Medicare fee-for-service payments, which can include over- or underpayments to providers in addition to fraud.

“The continued reduction in Medicare fee-for-service improper payments represents considerable progress toward the Biden-Harris Administration’s goal of protecting CMS programs’ sustainability for future generations. We intend to build on this success and take the lessons we’ve learned to ensure a high-level of integrity across all of our programs,” said CMS Administrator Chiquita Brooks-LaSure in a statement.

Most improper payments involve situations where a state or provider missed an administrative step, CMS officials said. While fraud and abuse may lead to improper payments, it is important to note that the vast majority of improper payments do not constitute fraud, and improper payment estimates are not fraud rate estimates.

Source: Improper Medicare payments down $20.7B since 2014, CMS data show / Fierce Healthcare

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