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Top 10 States For Medicare Waste Overbilled $2 Billion

FOR IMMEDIATE RELEASE                                               

CONTACT: Kristin Walter
kristin.walter@rubinmeyer.com
(202) 898-0995

 Top 10 States For Medicare Waste Overbilled $2 Billion
Council for Medicare Integrity releases annual list of most wasteful states

Washington, D.C. – The Council for Medicare Integrity (CMI) today released its list of the Top 10 States for Medicare Waste, compiled using data from the Center for Medicare and Medicaid Services (CMS) FY2013 RAC Report to Congress.

California tops the list with $517 million in overpayments from Medicare, improperly billing $150 million more than in FY2012. In additional year-over-year comparisons, Missouri moved up four slots from no. 8 in 2012 to no. 4 in 2013, with an increase in $85 million in improper payments; North Carolina came in at no. 7, compared to its previous no. 10 rank with an increase in improper payments of $82 million; and both Michigan and Ohio moved in to the top 10 rankings, with improper payment increases of $79 million and $69 million, respectively.

 State

 Overpayments
(rounded to nearest million)

 1. California  $517M
 2. New York  $309M
 3. Florida  $239M
 4. Missouri  $170M
 5. Pennsylvania  $153M
 6. Texas  $152M
 7. North Carolina  $147M
 8. Illinois  $114M
 9. Michigan  $108M
 10. Ohio  $105M

The Medicare Fee-For-Service program provides healthcare coverage for more than 50 million Americans across the nation. The program is currently slated to be insolvent in the next 15 years due to rampant waste, fraud and abuse within the Medicare system.“The rate of improper Medicare payments continues to climb year over year, causing the Medicare Trust Fund to hemorrhage resources,” said Kristin Walter, spokesperson for CMI. “In FY2014, providers overbilled Medicare by $60 billion[i], while asking the CMS to reduce the amount of Medicare oversight. It is clear that oversight is more necessary than ever to ensure that Medicare is still around for the generations that will rely on it in the future.”

In 2009, Congress created the Recovery Audit Contractor program to review post payment Medicare claims and claw back funds that were inappropriately paid out from the Medicare Trust Fund. These auditors review only 2 percent of a provider’s Medicare claims, but have thus far returned more than $8.9 billion to the Medicare Trust Fund since 2009, extending the life of the nation’s marquee healthcare program. Recovery auditors have been found to have a 96 percent[ii] accuracy rate in their reviews.

Recently, hospital and provider groups have aggressively lobbied Congress and CMS to reduce the amount of oversight of their Medicare billing, citing that they are “burdened” by these reviews.

For more information, please visit: www.medicareintegrity.org.

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About the Council for Medicare Integrity

The Council for Medicare Integrity is a 501(c)(6) non-profit organization. The Council’s mission is to educate policymakers and other stakeholders regarding the importance of healthcare integrity programs that help Medicare identify and correct improper payments.

As a 501(c)(6) organization, the Council files IRS Form 990s annually with the IRS as required by law. Copies of these filings and exemption application materials can be obtained by mailing your request to the Secretary at: Council for Medicare Integrity, Attention: Secretary, 9275 W. Russell Road, Suite 100, Las Vegas, Nevada 89148. In your request, please provide your name, address, contact telephone number and a list of documents requested.  Hard copies are subject to a fee of $1.00 for the first page and $.20 per each subsequent page, plus postage, and must be made by check or money order, payable to the Council for Medicare Integrity. Copies will be provided within 30 days from receipt of payment. These documents are also available for public inspection without charge at the Council’s principal office during regular business hours. Please schedule an appointment by contacting the Secretary at the address above.

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