Medicare: Over $1 Billion Should Be Recovered From Primary Health Insurers
HRD-92-52
Published: Feb 21, 1992. Publicly Released: Feb 21, 1992.
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Highlights
Pursuant to a congressional request, GAO reviewed Medicare contractors' efforts to administer Medicare Secondary Payer (MSP) program provisions intended to ensure that primary insurers pay claims before Medicare.
Recommendations
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Health and Human Services | The Secretary of Health and Human Services should direct the Administrator, HCFA, to initiate a request to the Office of Management and Budget (OMB) to release the necessary contingency funds for use in recovering mistaken payments owed to Medicare. |
Closed – Implemented
OMB released $19.9 million to Medicare contractors for recovering amounts owed Medicare by private insurers. Backlogs of about $1 billion existed. Medicare contractors had reduced these backlogs to about $136 million as of March 31, 1993. As a result of GAO's work and Medicare contractors' efforts, about $278 million was recovered from primary health insurers.
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Topics
Data collectionErroneous paymentsGovernment collectionsHealth insurance cost controlInsurance claimsMedical expense claimsMedicareQuestionable paymentsReimbursements to governmentMedicare payments