KHN Morning Briefing

Summaries of health policy coverage from major news organizations

HHS To Start With Beneficiaries Backlog In Medicare Claims Appeals

The Department of Health and Human Services moves to break up a big backlog of Medicare claims appeals, with beneficiary hearings taking precedent. In the meantime, The Fiscal Times looks at overpayment in private Medicare Fee-For-Service plans.

Kaiser Health News: As HHS Moves To End Overload Of Medicare Claims Appeals, Beneficiaries Will Get Top Priority
Medicare beneficiaries who have been waiting months and even years for a hearing on their appeals for coverage may soon get a break as their cases take top priority in an effort to remedy a massive backlog (Jaffe, 1/21).

The Fiscal Times: Medicare Execs Are Overpaying $35 Billion a Year … And They Don’t Seem to Care
Medicare’s Private Fee-For-Service Plans, just one of the many entitlement programs run by the Centers for Medicare and Medicaid Services, overpaid billers by $34.6 billion dollars in 2013, according to its own estimates. With an “improper payments” rate of 10.1 percent of outlays, Medicare FFS is one of numerous government programs that wastes tens of billions of taxpayer dollars annually yet does little to recover any of that cash. The agency’s contractors are reasonably good at recouping overpayments when they are identified. They had an 83 percent recovery rate in 2013, according to the annual report released by the Department of Health and Human Services (Garver, 1/21).

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