Medicare: Millions in Potential Recoveries Not Being Sought by Contractors
GENERAL ACCOUNTING OFFICE WASHINGTON DC HUMAN RESOURCES DIV
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This testimony focuses on the second MSP responsibility--part B contractors carriers efforts to recover mistaken Medicare payments after determining that beneficiaries have other insurance. The results of our work to data suggest that this aspect of the MSP program is also plagued with problems. First, carrier systems problems and relaxed payment controls have contributed to the increased volume of mistaken Medicare payments that must be recovered. Second, because of MSP funding cutbacks carriers have done little to collect mistaken payments from other insurers since October 1, 1989. The Health Care Financing Administration HCFA has no reliable information on the size of the backlog or the total dollars associated with mistaken payments. However, based on our work to date, we believe that carriers have paid hundreds of millions of dollars that should be recovered from other insurers.
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