Letter to CMS Regarding Fraud Prevention System Report


Excerpt: In the recent report, CMS announced that its Fraud Prevention System (FPS) has saved the agency over $210 million in fiscal 2013 by blocking improper Medicare reimbursements. White that seems like a large amount of money, in FY2014, Medicare costs will total about $603 billion dollars, or roughly $2.3 billion each business day. Therefore, the $210 million represents only a very small portion of what Medicare spends in one day, and only a tiny fraction of the estimated $50 billion in improper payments made by CMS each year. Moreover, the savings from every dollar spent, or purported return-on-investment (ROI), of 1.34 to 1 is far below other ROIs of 5 to 1 or 7 to 1 which HHS often cites in traditional anti-fraud work.

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Health (113th Congress)