More Action Needed to Reduce Beneficiary Underpayments.
Abstract
This report represents the results of follow-on work to an earlier report. That report, entitled 'Reasonable Charge Reductions Under Part B of Medicare,' addressed four areas where beneficiaries were subject to inequitable out-of-pocket costs for services covered by Medicare. This report contains another recommendation to the Secretary of HHS which we believe will provide further safeguards for preventing underpayments to beneficiaries for services covered by Medicare. Claims that are subject to relatively large reasonable charge reductions often involve underpayments which go undetected because of poor claims review. The Health Care Financing Administration (HCFA)--as part of its Contractor Performance Evaluation program and related Carrier Quality Assurance program should specifically address how well its contractors (carriers) review and resolve the discrepancies on these types of claims. This report also provides an assessment of HHS actions taken on recommendations made in the October 1980 report.
Document Details
- Document Type
- Technical Report
- Publication Date
- Sep 03, 1981
- Accession Number
- ADA108440
Entities
Organizations
- United States Government Accountability Office