Featured in Government News of the Week, Dec. 6, 2010, and Health Business Daily, Dec. 10, 2010

CMS reports decrease in MA payment error rate

Reprinted from MEDICARE ADVANTAGE NEWS, biweekly news and business strategies about Medicare Advantage plans, product design, marketing, enrollment, market expansions, CMS audits, and countless federal initiatives in MA and Medicaid managed care.

November 25, 2010Volume 16Issue 22

CMS said Nov. 16 that the MA payment error rate — based on payment year 2008 — was 14.1% or $13.6 billion, down from 15.4% or $12 billion for payment year 2007. The agency attributed the error-rate reduction to its recent work to account more accurately for improper payments and to a renewed focus on fighting fraud, waste and abuse. In addition, CMS reported a Medicare Part D payment systems error rate of 0.1%, a low-income subsidy payment error rate of 0.1%, a payment error rate related to Medicaid status for Medicare and Medicaid dual-eligible Part D enrollees of 1.8%, and a payment error rate related to Prescription Drug Event (PDE) data validation of 12.7%. Visit www.cms.gov.

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