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首页> 美国政府科技报告 >Medicare Contractors Lacked Controls to Prevent Millions in Improper Payments for High Utilization Claims for Home Blood-Glucose Test Strips and Lancets.
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Medicare Contractors Lacked Controls to Prevent Millions in Improper Payments for High Utilization Claims for Home Blood-Glucose Test Strips and Lancets.

机译：医疗保险承包商缺乏控制措施，以防止数百万人因家庭血糖测试条和柳叶刀的高利用率索赔而支付不当费用。

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This report summarizes the results of our individual reviews of the 4 contractors that processed claims for test strips and/or lancets for Jurisdictions A through D, which included all 50 States, 5 territories, and the District of Columbia. Those reviews determined whether high utilization claims for test strips and/or lancets that the contractors allowed for payment were supported in accordance with Medicare documentation requirements. This report also provides the results of our analyses of (1) testing frequencies ordered by physicians for unsupported high utilization claims (by treatment type, i.e., non-insulin-treated and insulin-treated beneficiaries) and (2) unsupported claims with overlapping service dates for the same beneficiary. The contractors allowed for payment $1.2 billion in Medicare Part B claims for test strips and/or lancets for calendar year (CY) 2007. We focused our reviews on high utilization claims. To identify these claims, we analyzed the information submitted by suppliers on the claim forms. We did not verify the accuracy of the claims information. We estimated that the contractors allowed for payment a total of $484.3 million for the claims that we identified as high utilization claims. Our objective was to summarize the results of our individual reviews of the four contractors that processed claims for test strips and/or lancets for Jurisdictions A through D.

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