Citing stepped-up oversight, the Centers for Medicare & Medicaid Services said the error rate for Medicare fee-for-service (FFS) claims continued to fall this year, to 3.9% from 4.4% in 2006 and 14.2% in 1996, when the improper payment rate was first reported.

The continued reduction is due, CMS said, to efforts by its contractors to use detailed data analysis to isolate areas of erroneous claims processing, inaccurate billing, and provider error. Insufficient documentation is one area targeted in particular, declining from 4.1% of the error rate in 2004 to 0.4% in 2007. During the past three years, error rate reductions have led to approximately $11 billion less in improper payments, CMS said. Medicare pays more than one billion fee-for-service claims each year.

CMS reports its Medicare FFS improper payment findings in an annual report. The complete report contains additional error rate information along with more specific improper payment estimates. It is posted at www.cms.hhs.gov/cert.

December 17, 2007 - Table of Contents

NIR December 17, 2007 (full PDF issue)

CMS Forging Ahead with Lab Bidding Demo in San Diego

Time Running Out for Physician Fee Fix

Advisory Panel Prescribes Changes for CMS, FDA in Genetic Test Oversight

January 1—Key Deadline for Use of National Provider Identifier

Medicare Improper Claims Payment Continues to Drop