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March 05, 2014 at 05:30 AM
Improving the traditional Medicare program summary notice system might be a simple way to detect more fraud.
Robert Vito, a regional inspector general at the U.S. Department of Health and Human Services Office of Inspector General (HHS OIG), made that case today at a hearing on Medicare program management organized by the House Energy & Commerce health subcommittee.
Vito talked about two new HHS OIG reports.
In one, investigators concluded that many Medicare Part D prescription drug program carriers either fail to participate in a voluntary fraud and abuse reporting program or participate in a perfunctory way.
In another, investigators found that the Centers for Medicare & Medicaid Services (CMS) typically makes poor use of the compliance reports it gets from Medicare Advantage plans.
Vito also talked about the fact that the U.S. Postal Service returned 4.2 million Medicare summary notices to Medicare administrative contractors (MACs) in 2012.
The MACs — including units of big health insurers and several large benefits administration companies — run the traditional Medicare program for CMS.
