July 22, 2015

GAO: More Than 23,000 Medicare Provider Addresses May Be Invalid.

stethoscope-29309_640The Wall Street Journal  (7/22, A1, Weaver, Subscription Publication) reports on its front page that a Government Accountability Office audit found that while Medicare overhauled its enrollment system and verification of provider information in recent years, up to 23,400 provider addresses – about 2.3 percent – may be invalid. The Centers for Medicare and Medicaid Services said some provider locations flagged by GAO didn’t turn out to be fraudulent, stemming instead from data-entry errors and out-of-date information. Shantanu Agrawal, the director of Medicare’s Center for Program Integrity, noted that “the moment a physician enters their data, it starts to change.”

The New York Times (7/22, A18, Pear, Subscription Publication) reports in brief coverage that investigators said Medicare “weakened its internal controls” when it revised its screening procedures last year, making it easier for some potentially ineligible providers to participate in the program. Medicare officials “said they had revoked billing privileges for almost 28,000 providers and suppliers in the last few years.”