OIG Issues Report on Overpayment Collections

Today, the Office of Inspector General (OIG) released an article detailing the results of their audit of overpayment collections made by the Centers for Medicare and Medicaid Services

(CMS) during fiscal years 2007 and 2008, as well as the first half of fiscal year 2009. The OIG reported that as of October 8, 2010, CMS had not collected the majority of overpayment amounts identified in OIG audit reports. Of the 154 OIG audit reports with sustained overpayment amounts totaling $416.3 million, CMS reported collecting $84.2 million. CMS cited time constraints related to the statute of limitations on overpayment collections as dampening their efforts. In addition, it did not provide its contractors with adequate guidance for collecting overpayments and did not have an effective system for monitoring its contractors’ collection efforts.

The OIG recommended that CMS:

(1) Pursue legislation to extend the statute of limitations so that the recovery period exceeds the reopening period for Medicare payments
(2) Ensure that its Audit Tracking and Reporting System (ATARS) is updated to accurately reflect the status of audit report recommendations
(3) Ensure that CMS staff record collections information consistently in ATARS
(4) Collect sustained amounts related to OIG recommendations made after our audit period to the extent allowed under the law
(5) Verify that the $84.2 million reported as collected has actually been collected
(6) Provide specific guidance to its contractors concerning the timeframe in which the contractor must take action to collect an overpayment, how to report collections, the type of documentation that the contractor must maintain to substantiate an overpayment collection, and how to report reasons for not collecting overpayments.

In response to the OIG's recommendations CMS concurred with the second, third, and sixth recommendations, partially concurred with the fourth recommendation, and did not concur with the fifth recommendation.

View the complete report at oig.hhs.gov