Another week brings us another HHS Office of the Inspector General (OIG) report criticizing the work of CMS, this time about the Medicare 
agency's failure to collect the vast majority of overpayments found in previous OIG audits.
According to the report, of the $416 million in overpayments found in OIG audits from late 2006 through early 2009, CMS has only collected about $84 million, meaning 80% of the apparently inappropriate reimbursements remained untouched and in providers hands.
In fairness to CMS, the agency could not recoup many of those overpayments because the allowed recovery period had already passed. OIG’s first recommendation to CMS is that it pursues “legislation to extend the statute of limitations so that the recovery period exceeds the reopening period for Medicare payments.” But CMS’ response hardly indicates such a pursuit will be its first priority – “CMS said that it would explore the possibility of pursuing legislative proposals.”
Bottom line: If you’ve received an overpayment in the late 2000s, there is no imminent threat that CMS, through its contractors, will retrieve that money. But don’t expect this lax policy to continue much longer. CMS has agreed to take action in response to OIG’s recommendations that CMS gets its house in order to ensure improved collection of overpayments in the future.
Read the full report here.