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Review of Medicare and Medicaid Duplicate Payments in Michigan

HRD-83-43 Published: Feb 22, 1983. Publicly Released: Feb 22, 1983.
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Highlights

GAO reviewed the practices and procedures of the Michigan Medicare carrier and Medicaid administrator to prevent duplicate payments to physicians with more than one provider identification number and to remove unlicensed physicians from the Medicare and Medicaid rolls.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Region V, Chicago, IL The Administrator, Region V, Health Care Financing Administration, should ensure that appropriate corrective actions are taken by the carrier and State to recover the erroneous payments identified and to update the provider rolls.
Closed – Implemented
As of April 1984, the carrier and State had recovered or obtained a court judgment to recover $923,537 in Federal and State funds and has also collected interest of $5,850. A net Federal collection of $469,464 has occurred.
Region V, Chicago, IL The Administrator, Region V, Health Care Financing Administration, should ensure that the carrier improves its manual review process.
Closed – Implemented
Carrier claims examiners were instructed on the proper duplicate payments. The carrier also revised its procedures for such claims.

Full Report

Full Report (8 pages)

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Topics

Health Care
Agency missionsCost controlstate relationsMedicareMedicaidOverpaymentsPhysiciansProgram abusesState programsPatient care