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CMS releases the Medicare fee-for-service 2013 improper payments report

Billing Alert for Long-Term Care, February 1, 2015

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Each year, CMS calculates the Medicare fee-for-service (FFS) improper payment rate through the Comprehensive Error Rate Testing (CERT) program. CERT evaluates a statistically valid random sample of claims to determine if they were paid properly under Medicare coverage, coding, and billing rules and publishes the Medicare Fee-for-Service Improper Payment Report. The estimated 2013 Medicare FFS compliance rate?the percentage of Medicare dollars paid correctly?was 89.9%. This calculation included claims submitted during the 12-month period from July 2011 through June 2012, meaning that Medicare paid an estimated $321.4 billion correctly during this time. The report documents the results of Recovery Audit Contractors' (RAC) fiscal year 2013 auditing efforts.

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Billing Alert for Long-Term Care.

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