According to a new Government Accountability Office (GAO) report, the Centers for Medicare and Medicaid Services (CMS) failed to properly audit private insurance companies for overpayments or to recover the excess payments. (Kaiser Network)
Medicare-participating private insurers kept “tens of millions of dollars” that could have been passed on to beneficiaries or returned to the government. Federal law requires CMS to audit financial records of at least one-third of such companies every year.
CMS contends that it has no legal authority to require private insurers to return overpayments. GAO claims otherwise; however, despite CMS’s failure to follow the law, the GAO said that “there is a low probability of the audits identifying intentional misrepresentations.”
