$23 Billion in Payment Errors by Medicare

Would you mistakenly pay for something over and over again? Of course not. But what if it wasn’t your money? You may not care as much. Well, it turns out that “Medicare made more than $23 billion in improper payments in fiscal 2017, a government watchdog report found, largely due to scant or no documentation. The Government Accountability Office also looked at improper payments in Medicaid fee for service, which amounted to about $4.3 billion.”

That’s $27 BILLION in total!!

Unbelievable and yet many want the government to take over the healthcare system fully? Marone!

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Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  4 comments for “$23 Billion in Payment Errors by Medicare

  1. Randy
    April 3, 2019 at 9:06 am

    I would take issue with categorizing these as payment errors, more likely the services were appropriate but the documentation didn’t meet the Medicare guidelines. Doug, you don’t have to deal with this in DPC but the documentation required for some of these service codes is pretty complicated and it’s very easy not to meet 100% of the guidelines. As an example I’ve stopped using G0439 since the guidelines are ridiculous in my view, and actually end up producing increased patient costs and worse medical care in some instances.

  2. PW
    April 3, 2019 at 8:21 am

    So-called healthcare these days is nothing more than a mob racket. I’m disgusted with it all.

  3. Seneca
    April 3, 2019 at 7:32 am

    Gotta watch government defined “payment errors”. They hire companies to scour medical records–particularly in hospitals where the big bucks are-and retrospectively determine that services were unnecessary. On top of that, the companies they hire to do these reviews get a bounty on whatever they can deny. I saw a case once where they thought a joint replacement should be denied retroactively because the patient didn’t have adequate documentation that he had taken enough Advil as conservative treatment before surgery!

    • Stevem64
      April 3, 2019 at 8:57 pm

      Agreed! This sounds like a way to start cutting Medicare payments further and do more documentation audits.
      These audits look at a few charts and then claim it is an accurate sample and multiply it by all of the Medicare encounters.
      You get a gigantic number and then they tack on the phrase “improper payments” or “Medicare fraud” or something else that sounds bad.

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