Today, Mark B. McClellan, M.D., Ph.D., Administrator of the Centers for Medicare & Medicaid Services (CMS), announced that aggressive oversight and new improvement efforts have cut the number of improper fee-for-service Medicare claims payments by half in one year, from 10.1 percent in 2004 to 5.2 percent in 2005, a $9.5 billion reduction in improper payments. Dr. McClellan also announced the first year of the national implementation to measure state-level Medicaid improper payments and a comprehensive strategy to assure appropriate payments to prescription drug plans. The Medicare fee-for-service error rate has declined from 14.2 percent in 1996, when the Medicare improper payment rate was first reported, to the current 5.2 percent. The unprecedented reduction in the error rate has occurred despite a growing volume of claims and complexity of payment processing at CMS. CMS pays more than 1 billion fee-for-service claims each year, and provides oversight to state payments for services provided by health care professionals under Medicaid and the State Children’s Health Insurance Program (SCHIP). In 2005, Medicare also made monthly payments to more than 450 Medicare health plans across the U.S. For more detailed information, please see the short report explaining these findings on the CMS website, CERT Reports webpage using the link below.
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