9 States, D.C. Made Up Lion’s Share Of Medicare Waste In 2015
This is the second consecutive year that the District of Columbia has topped all states in Medicare waste per beneficiary. In other news, Medicare officials warn Pennsylvania health plans that they could face fines if they don't fix their directories.
The Fiscal Times:
The 10 States With The Worst Medicare Waste
Despite stepped up efforts to crack down on Medicare fraud and wasteful spending, the federal government lost at least $43 billion in fiscal 2015 to health care providers who filed improper or bogus claims to the program, according to a new study. Nine states and the District of Columbia were responsible for the lion’s share of the total improper payments, according to a new study by the Council for Medicare Integrity, a non-profit government watchdog. The states include Texas with $50.2 million in improper payments, California with $47.8 million, New Jersey with $22.6 million and Pennsylvania $22.1 with million. (Pianin, 1/19)
Medicare Officials Warn Three Pa. Health Plans To Fix Physician Network Directories
Medicare has warned three Pennsylvania health plans that sell coverage for seniors to fix their physician network directories by Feb. 6 or face fines or enrollment bans. Highmark Health and its affiliate, Gateway Health Plan, both located Downtown, and Philadelphia-based Health Partners Plans Inc. were among 21 Medicare Advantage insurers warned by federal officials about high error rates in their online physician network directories. The Centers for Medicare & Medicaid Services, which oversees Medicare, conducted the audit, which was the government’s first in-depth look at the accuracy of provider directories. (Mamula, 1/19)