Viewpoint: $60B in improper Medicare payments deserves greater government attention

Though Attorney General Jeff Sessions has made a few highly-publicized crackdowns on fraudulent Medicare claims, the fact that $60 billion in improper Medicare payments are made every year should prompt an even greater government response, according to an op-ed penned by Adrian Velasquez in The Hill.

Mr. Velasquez is the founder and president of Fi-Med Management, a Brookfield, Wis.-based revenue and risk consulting agency for providers.

He writes that common billing errors — like duplicate charges, incorrect patient information and separated bundled procedures — add up to billions of dollars in improper payments. He suggests that predictive analytics and compliance tools can help providers track behavioral coding issues, but these changes must also receive greater government support.

"It is optimal to eliminate overpayments as well as underpayments," Mr. Velasquez writes. "Targeted analytics are a key component to turning non-protected health information data instantly into a comprehensive report that not only mitigates risk for compliance violations, but also finds lost revenue to hospital systems."

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