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Medicare Reviewers Fail To Investigate Error-Prone Health Care Providers

A new article by Modern Healthcare reveals the troubling truth about Medicare auditors’ failure to scrutinize providers who have been found to have committed a large number of medical errors. Typically the Center for Medicare and Medicaid Services (CMS) used historical error-rate data to identify the medical providers who committed the most medical mistakes and billing errors, and then worked to ensure corrective actions was taken.

However, those reviews never occurred for many error-prone facilities. As a result, an astounding $44 billion was paid over 4 years for incorrect procedure like fee-for-service payments stemming from incorrect coding, unnecessary services, and documentation errors.

Over the past 4 years, CMS data revealed that 21% of the inpatient acute-care providers accounted for nearly 59% of the errors-meaning that a smaller group of providers were committed repeated mistakes and compounding the overall problem.

Since the lack of proper auditing has been identified, the inspectors general’s office is recommending that CMS require providers to identify the causes of their errors and create plans to prevent future harm. The new administration is now focused on ensuring that steps are taken to provide better auditing of Medicare errors and corrective plans.

Our Chicago medical malpractice attorneys at Levin & Perconti believe that all medical providers should abide by the law at all times. Lax standards in the form of Medicare payment mistakes indicate a willingness to bend the law and cut corners for financial savings. When that same standard is applied to the treatment of patients, than severe harm is likely to strike. Medical malpractice lawyers are focused on holding those negligent providers accountable for their cost-cutting steps that harm patients to ensuring that steps are taken to correct the errors.