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Improper pay rates down $4.59 billions, CMS says

November 20, 2018
by I Advance Senior Care
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The Medicare fee-for-service improper payment rate in 2018 is the lowest it has been since 2010. A sharp drop in home health improper payments, in particular, is a big part of the reason why, according to Home Health Care News.

Improper payments decreased by roughly $4.59 billion from 2017 to 2018, according to the U.S. Centers for Medicare & Medicaid Services (CMS), which highlighted the reduction late Friday afternoon. For the first time in improper payment reporting history, CMS recorded improper payment rate reductions in Medicare, Medicaid and the Children’s Health Insurance Program.

Specifically, the 2017 Medicare fee-for-service improper payment rate was 9.51%. The rate dropped to 8.12% in 2018.

CMS has taken several measures aimed at reducing improper Medicare payments to post-acute care providers in recent years. They include, for example, the 2016 Pre-Claim Review Demonstration and this year’s revised Review Choice Demonstration version.

The measures are necessary, CMS officials argue, because roughly 20% of U.S. tax dollars are spent on health care.

Home health corrective actions have resulted in a $6.92 billion decrease in estimated improper payments from 2015 to 2018, according to CMS. Additionally, the home health improper payment rate decreased from 58.95% in 2015 to 17.61% in 2018.

Read the full story at Home Health Care News.

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