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Where To Report Waste Fraud, Abuse, Or Retaliation

Medicare Could Have Saved Up To $128 Million Over 5 Years if CMS Had Implemented Controls To Address Duplicate Payments for Services Provided to Individuals With Medicare and Veterans Health Administration Benefits

Submitting OIG: 
Department of Health & Human Services OIG
Date Issued: 
Monday, April 24, 2023
Agency Reviewed / Investigated: 
Department of Health & Human Services
Submitting OIG-Specific Report Number: 
A-09-22-03004
Component, if applicable: 
Centers for Medicare & Medicaid Services
Centers for Medicare and Medicaid Services
Location(s): 
United States
Type of Report: 
Audit
Questioned Costs: 
$0
Funds for Better Use: 
$127,981,462
Number of Recommendations: 
4
Report updated under NDAA 5274: 
No
View Document: 
AttachmentSize
PDF icon 92203004.pdf1.73 MB

Related Open Recommendations

Recommendation Number Recommendation Status Significant Recommendation Additional Details
23-A-09-066.01 Open No
We recommend that the Centers for Medicare & Medicaid Services establish a comprehensive data-sharing agreement with VHA for the ongoing sharing of data.
23-A-09-066.02 Open No
We recommend that the Centers for Medicare & Medicaid Services establish an interagency process to integrate VHA enrollment, claims, and payment data into the CMS IDR to identify potential fraud, waste, and abuse under the Medicare program.
23-A-09-066.03 Open No
We recommend that the Centers for Medicare & Medicaid Services establish an internal process (such as system edits) to address duplicate payments made by Medicare for medical services authorized and paid for by VHA, which could have saved Medicare up to $128 million during our audit period.
23-A-09-066.04 Open No
We recommend that the Centers for Medicare & Medicaid Services issue guidance to providers on not billing Medicare for a medical service that was authorized by VHA.
Displaying 4 of 4 Recommendations