From 2017-18 alone, a decrease in improper payment rates led to $4.59 billion in savings. Reductions in improper payment rates were achieved collectively across Medicare, Medicaid and the Children’s Health Insurance Program for the first time.
The Medicare fee-for-service improper payment rate fell from 9.51 percent in 2017 to 8.12 percent in 2018. In addition, corrective actions in the home health sphere led to a $6.92 billion decrease in improper payments from 2015-18.
“CMS employs multi-faceted efforts to target the root causes of improper payments, with an emphasis on prevention-oriented activities,” CMS said. These include prior authorization, claim error corrections and provider education on Medicare policy, among others.
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