by William Upton at The National Pulse
The federal government’s Centers for Medicare and Medicaid Services (CMS) has issued an estimated $1.1 trillion in improper payments over the last decade, according to a new outside analysis. While CMS’s internal audits suggest at least $543 billion in improper payments over a decade, the Paragon Health Institute—an independent and nonpartisan healthcare think tank—says its research reveals the fraudulent payments are over double what the government reports.
According to researchers with the Paragon Health Institute, CMS data excludes eligibility checks, which produces a lower, inaccurate cost for fraudulent payments. The researchers note that CMS’s Payment Error Rate Measurement (PERM) audits under both the Obama and Biden governments excluded analysis of state eligibility determinations resulting in an inaccurate estimation of improper payments.
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