Topic: Improper Payments

An HHS investigation discovered that CMS paid millions of dollars for skilled nursing facility services without meeting the proper guidelines.

Cognizant will pay the SEC a $25 million settlement, while the DOJ indicted two former executives, all related to an alleged bribery scheme in India.

CMS has failed to recover more than half of the nearly $3 billion in Medicaid overpayments identified by auditors over an 11-year period.

The OIG also found that beneficiaries spent $8.7 million in unnecessary deductibles and coinsurance from 2015-2017.

Improper payments reached an eight-year low of 8.12% in the Medicare fee-for-service program this year.

California’s Medicaid program made at least $4 billion in questionable payments to health insurers and medical providers over a four-year period.

CMS expects to collect $4.5 billion in improper payments thanks to a proposal that would expand the agency's auditing capabilities.

Of the nearly $7 billion Medicare paid to inpatient rehab hospitals in 2013, $5.7 billion was deemed improper.

Recovery audit contractors (RACs) returned $214 million to the Medicare program in fiscal year 2016.

Many articles in medical journals are missing a key piece of information: the financial ties of the authors.