Health Information Management

HHS' Agency Financial Report details improper payment ups and downs

HIM-HIPAA Insider, November 23, 2015

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HHS released its annual Agency Financial Report last week. The report includes updates on the improper payment rates for several CMS programs for FY 2015, including Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). The report shows a decrease in improper payments and a corresponding increase in correct coding as well as correct and complete supporting documentation for services provided, according to CMS.

However, some areas showed slight increases in improper payments. Medicaid improper payment rates increased from 6.7% in FY 2014 to 9.8% in FY 2015. Improper CHIP payment rates increased from 6.5% to 6.8%. Medicaid Part D improper payment rates saw a 0.3% increase in FY 2015. CMS attributes these increases to new provider enrollment and screening requirements from the Affordable Care Act and HIPAA. The new requirements will strengthen Medicaid and CHIP programs and lead to improper payment rate decreases in the coming fiscal year, according to CMS.

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