Medicare Program: Additional Actions Are Needed to Improve Eligibility Verification of Providers and Suppliers

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By Seto J. Bagdoyan (au)
Year: 2015
Pages: 64
Binding Paperback
ISBN 978-1-4578-6983-9

Product Code: 1457869837

Description

In FY 2014, Medicare paid $554 billion for health care and related services. The Centers for Medicare & Medicaid Services (CMS) estimates that $60 billion (about 10%) of that total was paid improperly. To establish and maintain Medicare billing privileges, providers and suppliers must be enrolled in a CMS database known as the Provider Enrollment, Chain and Ownership System (PECOS). About 1.8 million providers and suppliers were in PECOS as of December 2014. This report examines the extent to which CMSäó»s enrollment-screening procedures are designed and implemented to prevent enrollment of ineligible or potentially fraudulent Medicare providers. Tables and figures. This is a print on demand report.

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