OIG: CMS leaves Medicare overpayments on the table

The Centers for Medicare & Medicaid Services left $332.1 million on the table, which it didn't collect on because of the statute of limitations on overpayment collections, the Office of the Inspector General said in a report, released Thursday.

Of the $416.3 million that identified as overpayments, CMS didn't collect on $332.1 million as of October 2010. In addition, OIG couldn't verify whether CMS actually collected on the other $84.2 million due to reporting inaccuracies.

OIG had recommended collections on overpayments greater than $1,000 that were issued during fiscal years (FY) 2007 and 2008 and the first six months of FY 2009 to CMS, CMS contractors or Medicare providers. However, OIG noted that a number of obstacles impeded CMS' ability to collect on those overpayments.

For example, CMS did not have adequate systems for documenting collections or detecting data entry errors. "Therefore, CMS had no assurance that the overpayment collections information that it reported to other parties was accurate," OIG said.

This isn't the first report in which the OIG has criticized CMS for its faulty auditing and collecting. The agency has suggested that the Medicare and Medicaid recovery programs are slow and therefore ineffective, particularly in its anti-fraud efforts.  

Under the Patient Protection and Affordable Care Act, as of March 2010, persons who receive an overpayment must report and return it within 60 days. The Act could affect future overpayment recoveries, OIG said in the report.

To learn more:
- read the OIG summary and report (.pdf)

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