Government-Run Health Insurance Program Made Almost $19 Billion in Improper Payments in 2008
Published: 2009-06-04 22:59:25
Author: Marie Magleby | CNS News | May 1, 2009
(CNSNews.com) - Medicaid, the government-run health insurance program for low income people that is administered by state governments and funded by federal taxpayers, made almost $19 billion in improper payments in 2008, according to a report by the Government Accountability Office last week.
These improper payments equaled the largest share--26 percent--of all improper government payments in 2008.
But most of those payments were the result of errors, not deliberate fraud, according to the U.S. Department of Health and Human Services (HHS), which oversees Medicaid.
Improper payments include payments to ineligible persons or for ineligible services, duplicate payments, payments for services not received or full payments made when discounts might apply.
According to the report, the U.S. government made an estimated $72 billion overall in improper payments last year. Of that total, Medicaid doled out almost $19 billion. Seventy-seven other programs were responsible for the remaining $53 billion, and 11 other programs did not report estimates for 2008.
But in an April 22 appearance before Congress, Deborah Taylor, acting director and chief financial officer of the Centers for Medicare & Medicaid Services at HHS, testified that procedural glitches, not fraud, are the biggest cause of the problem.
“Most of the improper payments . . . are generally not due to willful fraud,” she told a panel of the Senate Homeland Security and Governmental Affairs Committee. “Rather, most of these errors are the result of documentation and processing mistakes.”
These mistakes include inadequate documentation--which accounted for 90 percent of the improper payments--pricing errors and payment for non-covered services. Taylor also noted that “improper payments due to payment system errors are routinely resolved and payment adjustments are made.”
Full story
Published: 2009-06-04 22:59:25
Author: Marie Magleby | CNS News | May 1, 2009
(CNSNews.com) - Medicaid, the government-run health insurance program for low income people that is administered by state governments and funded by federal taxpayers, made almost $19 billion in improper payments in 2008, according to a report by the Government Accountability Office last week.
These improper payments equaled the largest share--26 percent--of all improper government payments in 2008.
But most of those payments were the result of errors, not deliberate fraud, according to the U.S. Department of Health and Human Services (HHS), which oversees Medicaid.
Improper payments include payments to ineligible persons or for ineligible services, duplicate payments, payments for services not received or full payments made when discounts might apply.
According to the report, the U.S. government made an estimated $72 billion overall in improper payments last year. Of that total, Medicaid doled out almost $19 billion. Seventy-seven other programs were responsible for the remaining $53 billion, and 11 other programs did not report estimates for 2008.
But in an April 22 appearance before Congress, Deborah Taylor, acting director and chief financial officer of the Centers for Medicare & Medicaid Services at HHS, testified that procedural glitches, not fraud, are the biggest cause of the problem.
“Most of the improper payments . . . are generally not due to willful fraud,” she told a panel of the Senate Homeland Security and Governmental Affairs Committee. “Rather, most of these errors are the result of documentation and processing mistakes.”
These mistakes include inadequate documentation--which accounted for 90 percent of the improper payments--pricing errors and payment for non-covered services. Taylor also noted that “improper payments due to payment system errors are routinely resolved and payment adjustments are made.”
Full story