NYT: Audit Cites Overpaid Medicare Insurers

[Omaha Steve]

http://www.nytimes.com/2007/09/10/health/policy/10medicare.html?ei=5088&en=e03d47c31014d0b7&ex=1347076800&partner=rssnyt&emc=rss&pagewanted=print

Audit Cites Overpaid Medicare Insurers
By ROBERT PEAR

WASHINGTON, Sept. 9 — Private insurance companies participating in Medicare have been allowed to keep tens of millions of dollars that should have gone to consumers, and the Bush administration did not properly audit the companies or try to recover money paid in error, Congressional investigators say in a new report.

The investigators, from the Government Accountability Office, said the money could have been used to reduce premiums or provide additional benefits to older Americans.

Under federal law, Medicare officials are supposed to audit the financial records of at least one-third of the insurance companies each year. But the investigators said the Bush administration had fallen far short of that goal and had never met the “statutory requirement.”

Indeed, they said, the proportion of companies audited by Medicare declined steadily — to 14 percent in 2006 from 24 percent in 2001 — despite a steady growth in Medicare payments to the plans. Those payments now total $75 billion a year, about one-fifth of all Medicare spending.

The Bush administration did not take issue with the findings.

“We welcome constructive suggestions for improving the audit process,” said Tim Hill, chief financial officer at the Centers for Medicare and Medicaid Services. An agency spokesman said it might need additional legislative authority to clarify its power to recoup money from insurers.

FULL story at link.

[indepat]

1. How convenient and now isn't that special? I'm shocked