According to the Centers for Medicare and Medicaid Services (CMS), private auditors have recovered close to $700 million in improper Medicare payments to providers in six states, including New York, California, and Florida.
Eighty-five percent of overpayments was collected from inpatient hospitals, six percent from inpatient rehab facilities, and four percent from outpatient hospital providers.
CMS pays private auditors a portion of Medicare payments found to be “improper.” Is this a conflict of interest? At any rate, auditors reviewed $317 billion in Medicare claims and found that overpayments accounted for $992.7 million of the improper payments and underpayments accounted for $38 million; however, providers were able to successfully challenge 4.6 percent of those payments.
