A Medicare Fraud 2.0 Prediction

Join Our Mailing List

More on Healthcare Fraud and Abuse with Video

Edward Bukstel

 By Edward Bukstel



Medicare Fraud 2.0 Prediction.




Channel Surfing the ME-P

Have you visited our other topic channels? Established to facilitate idea exchange and link our community together, the value of these topics is dependent upon your input. Please take a minute to visit. And, to prevent that annoying spam, we ask that you register. It is fast, free and secure.

More: Submitted by Perry D’Alessio CPA


Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com


Product DetailsProduct Details


One Response

  1. More on Health Fraud

    There is no question that real fraud, waste and abuse exist. The Office of Inspector General of the Department of Health and Human Services (HHS) saved American taxpayers a record $21 billion a dozen years ago, according to Inspector General Janet Rehnquist. Savings were achieved through an intensive and continuing crackdown on waste, fraud and abuse in Medicare and over 300 other HHS programs for which the Office of Inspector General (OIG) has oversight responsibility.

    More recently, according to the Centers for Medicare and Medicaid Services [CMS] and under the tenure of Eric Himpton Holder, Jr., 82nd Attorney General of the United States, Recovery Asset Contractors [RACs] collected almost $1-B in improper payments during their beta testing period in 2009-10. Of these payments; 96% were over-payments, 4% were under-payments; and 77% of providers failed to appeal, 7% appealed successfully and 15% appealed unsuccessfully. And, by Fiscal Year 2016, recovery auditors collectively identified and corrected more than 1,532,249 claims for improper payments, which resulted in more than $3.75 billion dollars in improper payments being corrected. The total corrections identified include more than $3.65 billion in overpayments collected and $102.4 million in underpayments repaid to providers and suppliers.

    After taking into consideration all fees, costs, and first level appeals, the Medicare FFS Recovery Audit Program returned over $3.0 billion to the Medicare Trust Funds. These savings did not take into account program costs and administrative expenses incurred at the third and fourth levels of appeal (Office of Medicare Hearings and Appeals (OMHA) and Medicare Appeals Council within the Departmental Appeals Board (DAB), respectively), as these components do not receive Recovery Audit Program funding for those appeals.

    Dr. David Edward Marcinko MBA CMP™


Leave a Reply

Please log in using one of these methods to post your comment:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: