Medicare: Excessive Payments for Medical Supplies Continue Despite
Improvements (Testimony, 10/02/95, GAO/T-HEHS-96-5).

GAO discussed Medicare payments for medical supplies. GAO noted that:
(1) Medicare's payment rates for surgical dressings are generally
excessive, compared to wholesale and retail prices; (2) Medicare
contractors that process claims for hospitals and nursing homes are
unable to identify specific items being billed, which makes it difficult
to determine whether the total charges are reasonable; (3) Medicare
contractors that process claims for providers have paid for some
surgical dressings without first reviewing the claims before payment;
(4) claims processing contractors cannot cross-reference payment records
to identify possible duplicate payments; and (5) the fee-schedule
approach provides a good starting point for setting appropriate Medicare
prices, but the Health Care Financing Administration needs greater
flexibility to adjust fee schedule prices when market conditions warrant
such changes.

--------------------------- Indexing Terms -----------------------------

 REPORTNUM:  T-HEHS-96-5
     TITLE:  Medicare: Excessive Payments for Medical Supplies Continue 
             Despite Improvements
      DATE:  10/02/95
   SUBJECT:  Medicare programs
             Medical supplies
             Overpayments
             Internal controls
             Medical expense claims
             Program abuses
             Fraud
             Claims processing
             Billing procedures

             
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