Medicare fraud costs CMS billions

Medicare fraud continues to drain billions from federal coffers, though the volume of CMS overpayments and errors has fallen over the past two years, according to CMS's top official. Acting CMS administrator Leslie Norwalk told the House Energy and Commerce Subcommittee on Health that the agency has seen a significant jump in fraud and abuse over the past few years. Fraud among DME vendors, orthotics, prosthetics and supplies vendors continues to be a trouble spot, Norwalk said. For example, some of these vendors are paying kickbacks to physicians who prescribe high-cost equipment, or filing claims for equipment that is never delivered or not needed by the beneficiary. Since 1997, Medicare and fraud prosecutions has brought in $11 billion in fines and settlements since 1997. On the other hand, CMS officials testified that Medicare mistakes such as overpayments are dropping, with errors likely to hit 4.3 percent this year, compared with 5.2 percent in 2005.

To learn more about the problem:
- read this Kaiser Daily Health Policy Report item