tci Medicare Compliance & Reimbursement - 2003 Issue 20

Overpayments: CONTRACTORS TOUT PAYMENT SAFEGUARD HAULS

Medicare contractors are boasting once again about the financial fallout from their medical review, fraud-fighting and other payment safeguard activities. Regional home health intermediary Palmetto GBA, for example, is touting the $872 million it withheld or recouped from providers in 2002 as costs savings to the government. Palmetto's benefit integrity unit helped "identify and pursue highly abusive and/or fraudulently billed services" to the tune of $98.8 million. Provider audits recovered $101.8 million and secondary payer efforts resulted in $400 million, the RHHI says. Meanwhile sister company Trailblazer Health Enterprises LLC boasts $832 million in payment safeguard savings...

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