Review of Widespread Errors in the Listing of Medicare Payments Over $100,000 Released by HEW

HRD-78-32: Published: Feb 7, 1978. Publicly Released: Feb 7, 1978.

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A review was undertaken of the Health Care Financing Administration's Medicare Bureau's listing of physicians and group practices receiving over $100,000 in Medicare payments.

In its review, GAO found that errors in the listing were caused primarily by the inaccurate and incomplete data that the Bureau used in preparing the list. The list was prepared within an unnecessarily tight time limit. To develop the data, the Bureau relied on an information base, the Payment Review Project, with source data coming from two separate but related computer files, the Payment Record File and the Payment Record Reference File. Bureau officials knew that the files contained inaccuracies and incomplete information so a cover sheet was prepared to caution users that the list contained errors. Apparently, there was little or no proofreading of the listing prior to publication. Over 470 physicians complained about errors in the listing. Approximately 300 of the complaints concerned the use of an individual physician's name to identify a group practice, and there were about 100 complaints that physicians in group practices were listed as solo practitioners. A list of corrections was released to clarify the situations in which physicians complained that there were mistakes or misunderstandings.

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