OIG dice Seguro de enfermedad centrarse en doctores “error-prone”

por Brendon Nafziger, DOTmed News Associate Editor | November 08, 2010
Medicare officials could potentially help cut billions in wasteful spending by focusing their efforts on "error-prone providers," according to a report released last month by Office of Inspector General of the U.S. Department of Health and Human Services.

American Medical News reports that the OIG says Centers for Medicare and Medicaid Services administrators have not been using available error data to find doctors and medical equipment suppliers with a history of claims mistakes.

The OIG says CMS should identify error-prone providers, force them to develop action plans to fix their mistakes, and track the progress of their reforms. The agency also asks Medicare to share information with recovery audit contractors and quality improvement groups.

Between 2005 and 2008, the OIG says it discovered 740 physicians and suppliers with at least one error in each audit year. These errors, including incorrect coding, medically unnecessary services, documentation errors and others, accounted for most of the $44.1 billion in improper payments, when taken across the whole Medicare system, during that fiscal period, according to the AMN report.

In an August letter to the OIG, the CMS said it was taking "aggressive actions" in response to the recommendations.