Subpar provider enrollment screening processes continue to plague Medicare and Medicaid, leaving both programs vulnerable to fraud and contributing to nearly $90 billion in improper payments in 2015, according to testimony during a House subcommittee hearing.
In her testimony Tuesday, Ann Maxwell, assistant inspector general at the Office of Inspector General (OIG), noted that provider enrollment is a “key component” to minimizing improper payments. She also urged the Department of Health and Human Services (HHS) to “redouble its efforts” to ensure it is paying the right provider for the right service. Previous reports have indicated that eliminating improper payment is critical to sustaining Medicaid, and a recent independent audit found HHS failed to hit its target improper payment rate of less than 10 percent.
Source: Incomplete provider screening leaves Medicare, Medicaid open to fraud – FierceHealthPayerAntiFraud