Jul

16

CMW News: CMS develops program to prevent Medicare fraud

By Case Management Weekly

After findings suggested that CMS has paid more than $92 million to fraudulent Medicare claims for durable medical equipment (DME), the organization recently announced it has implemented a system to eliminate the deception.

The fraudulent claims involved using deceased physician Medicare identification numbers to receive payment for DME, according to Fierce Healthcare. CMS discovered the fraud when they ran a check of the American Medical Association’s list of deceased physicians against the list of Medicare claims from 1992 to 2002. It found it had paid claims to 734 physicians out of a random sample of 1,500. Those 734 names had been used to file 21,458 claims.

CMS says that it will now match Social Security Administration deaths data against the new Medicare provider-identification number system on a monthly basis.

Sources: Fierce Healthcare, The Washington Post