Researchers from the Office of the Inspector General (OIG) have estimated that Medicare contractors nationwide overpaid physicians $28.8 million for incorrectly coded services provided during 2008 and 2009.
Attributed to internal control weaknesses in physician billing and insufficient postpayment reviews at the Medicare contractor level to identify potential place-of-service coding errors, OIG’s estimates found that physicians were overpaid $19.3 million in 2008 and $9.5 million in 2009.
Published in September, OIG said that the Centers for Medicare & Medicaid Services (CMS) concurred with OIG’s recommendations in its draft report, yet had requested that OIG provide data to recover overpayments for the sampled and nonsampled services.
CMS, according to its response, will consider reviewing the appropriate claims based on the cost effectiveness of the review. “CMS considers return on investment when conducting medical review due to the limited resources associated with medical review activities,” wrote CMS Administrator Donald Berwick in an Aug. 4 letter.