New federal data estimates that the Centers for Medicare and Medicaid Services (CMS) paid $31 billion in improper payments in FY 2018, which equals about 8.12 percent of all claims paid in that period. That is the lowest improper payment rate for Medicare fee-for-service since 2010.
Representatives of CMS suggested the agency’s efforts to create a more targeted claims auditing process contributed to the reduction in improper payments. CMS indicated it may increase its use of prior authorization for some services and continue educating providers regarding documentation and prior authorization requirements to keep reducing improper payments.
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