CMS has only collected 55 percent of Medicare overpayments identified in HHS Office of Inspector General audits from eight years ago, the inspector general said this week.
The inspector general reviewed 148 Medicare audit reports issued between Oct. 1, 2014, and Dec. 31, 2016, according to a report it released July 25. CMS agreed to collect $498 million in overpayments found in those audits.
CMS said it collected $272 million of the overpaid claims identified in the audit but only had supporting documentation that it collected $120 million, according to the inspector general's report.
The inspector general advised that CMS continue its efforts to recover the remaining $226 million in overpayments and made nine recommendations.
Among the recommendations:
- Establish policies that define and require retention of documentation that is needed for independent verification of the collection of overpayments
- Ensure employees follow established policies and procedures for verifying that collection information is accurately and consistently recorded
- Establish policies and procedures that require staff to clearly describe the reasons for non-collection of an overpayment
CMS concurred with the recommendation to consider collection efforts, but did not concur with seven recommendations, according to the report. CMS did not explicitly state whether it concurred with one recommendation.
Read the full report here.