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U.S. recaptured Medicare Advantage overpayments of $1.25 billion in 2011

April 2, 2012
by Patricia Sheehan
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The U.S. Government Accountability Office reports that recovery audit contractors and other quality initiatives resulted in the recapture of $1.25 billion in Medicare Advantage overpayments to contractors and vendors last year.

More than half of the amount, $797 million, is attributed to the Medicare recovery audit contractor program. Cumulatively, $1.9 billion was reportedly recaptured from overpayments to contractors, vendors and healthcare providers for fiscal years 2010 and 2011 toward the Obama administration’s goal of recapturing at least $2 billion by the end of fiscal year 2012.

According to the report, recent strategies to help reduce improper payments include analysis of the root causes of improper payments which assist agencies in targeting corrective actions and implementing preventive measures. Preventive controls include validation of eligibility using data sharing, predictive analytic technologies and training programs.

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