A new report by the HHS Office of the Inspector General concludes that protecting Medicare, Medicaid and the State Children's Health Insurance Program from fraud and billing mistakes will prove to be the agency's biggest challenges this year. The OIG also identified oversight of Medicare's prescription-drug program, quality of care and emergency preparedness as issues.
Medicare, Medicaid and SCHIP are obviously high-stakes targets for fraud, given their sheer scale alone. The three programs burn through $611.5 billion in federal spending each year. The inspector general notes that they're hit by everything from reimbursements for services provided but not documented correctly and simple mistakes, to intentional fraud. Medicare alone pays out about $60 billion a year in improper payments to fraudsters, according to Congressional research.
To learn more about the report:
- read this Modern Healthcare piece (reg. req.)
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