Fact Based List:

CMS Fraud Prevention System Identified Savings from (First/Second) Year (millions)

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  1. Amount denied by pre payment edits 11.5/16.8
  2. Billed amount denied by auto-denial edits 4.7/1.6
  3. Payment suspensions 1.6/2.3
  4. Amount of overpayments referred for recovery 4.4/35.6
  5. Value of law enforcement referrals 68.2/73.2
  6. Cost avoidance due to changes in behaviour 11.1/NA
  7. Cost avoidance from revoking provider billing privileges 13.9/81.2
  8. Total 115.4/210.7


Source: Centers for Medicare & Medicaid Services
Source URL: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-relea...



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