The Resource Medicare Program Integrity : greater prepayment control efforts could increase savings and better ensure proper payment : report to congressional requesters, (electronic resource)

Medicare Program Integrity : greater prepayment control efforts could increase savings and better ensure proper payment : report to congressional requesters, (electronic resource)

Label
Medicare Program Integrity : greater prepayment control efforts could increase savings and better ensure proper payment : report to congressional requesters
Title
Medicare Program Integrity
Title remainder
greater prepayment control efforts could increase savings and better ensure proper payment : report to congressional requesters
Title variation
  • Greater prepayment control efforts could increase savings and better ensure proper payment
  • Medicare prepayment edits
Creator
Subject
Language
eng
Summary
CMS reported an improper payment rate of 8.6 percent ($28.8 billion) in the Medicare fee-for-service program for fiscal year 2011. To help ensure that payments are made properly, CMS uses controls called edits that are programmed into claims processing systems to compare claims data to Medicare requirements in order to approve or deny claims or flag them for further review. GAO was asked to assess the use of prepayment edits in the Medicare program and CMS's oversight of MACs, which process claims and implement some edits. This report examines the extent to which (1) CMS and its contractors employed prepayment edits, (2) CMS has designed adequate processes to determine the need for and to implement edits based on national policies, and (3) CMS provides information, oversight, and incentives to MACs to promote use of effective edits. GAO analyzed Medicare claims for consistency with selected coverage policies, reviewed CMS and contractor documents, and interviewed officials from CMS and selected contractors
Cataloging source
VVK
Government publication
federal national government publication
Illustrations
illustrations
Index
no index present
Literary form
non fiction
Nature of contents
  • dictionaries
  • bibliography
http://bibfra.me/vocab/lite/organizationName
United States
http://library.link/vocab/subjectName
  • Centers for Medicare & Medicaid Services (U.S.)
  • Centers for Medicare & Medicaid Services (U.S.)
  • Centers for Medicare & Medicaid Services (U.S.)
  • Medicare
  • Letting of contracts
  • Medicare fraud
  • Waste in government spending
  • Medicare
  • Fee-for-Service Plans
  • Expenditures, Public
  • Letting of contracts
  • Medicare
  • Medicare fraud
  • Waste in government spending
  • United States
Label
Medicare Program Integrity : greater prepayment control efforts could increase savings and better ensure proper payment : report to congressional requesters, (electronic resource)
Instantiates
Publication
Note
  • Title from title screen (viewed Dec. 31, 2012)
  • "November 2012."
  • QR code for online version of document included on title page
  • "GAO-13-102."
Bibliography note
Includes bibliographical references
Color
mixed
Dimensions
unknown
Extent
1 online resource (iii, 57 pages)
Form of item
online
Other physical details
ill.
Specific material designation
remote
System control number
  • (OCoLC)823391728
  • (OCoLC)ocn823391728
Label
Medicare Program Integrity : greater prepayment control efforts could increase savings and better ensure proper payment : report to congressional requesters, (electronic resource)
Publication
Note
  • Title from title screen (viewed Dec. 31, 2012)
  • "November 2012."
  • QR code for online version of document included on title page
  • "GAO-13-102."
Bibliography note
Includes bibliographical references
Color
mixed
Dimensions
unknown
Extent
1 online resource (iii, 57 pages)
Form of item
online
Other physical details
ill.
Specific material designation
remote
System control number
  • (OCoLC)823391728
  • (OCoLC)ocn823391728

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