“A new report by the nonpartisan Government Accountability Office (GAO) is making recommendations that the Centers for Medicare & Medicaid Services (CMS) take action to help address improper payments in the Medicaid program.”
“The report, which was requested by the committee, found that CMS’ current efforts to accurately estimate the improper payment rate for Medicaid managed care payments do not account for overpayments and unallowable costs. GAO found that the managed care component of the Payment Error Rate Measurement (PERM) review only measures capitated payments, and therefore does not account for all of the program integrity risks within Medicaid managed care…”
“GAO recommended CMS take additional action to account for the types of improper payments not accounted for in their PERM estimates. The Department of Health and Human Services agreed with the recommendation…” Read the full press release here.
Source: GAO Calls on CMS to Take Further Action on Efforts to Limit Improper Payments – June 6, 2018. Energy Commerce.
