Correcting overpayments in Medicare Advantage program could save billions: GAO
By Paul Wilson
ProWEB Wire (Industry News)
Correcting Medicare Advantage overpayments could save the government billions of dollars, according to a new report from the Government Accountability Office.
Due to a coding different between the Medicare Advantage program and the fee-for-service program, Medicare Advantage beneficiaries have been classified as less healthy than if they were under traditional Medicare, the report said.
MA plans were overpaid by $1.2 billion to $3.1 billion in 2010, according to the GAO.
Democrats consider MA overpayment as a primary way to reduce waste.
The report said that the Centers for Medicare & Medicaid Services could improve the accuracy of its risk score adjustments by incorporating the most recent data available for beneficiary characteristics as well as “accounting for all relevant years of coding differences, and incorporating the effect of coding difference trends.”