Report raises concerns about Medicare lab billing

Medicare allowed $1.7 billion in payments to laboratories in 2010 for claims that raised red flags, according to a report by the Department of Health and Human Services' Office of Inspector General. Meanwhile, home health care and hospice provider Amedisys says the SEC's probe of the company's participation in Medicare led to no enforcement actions.

The Wall Street Journal: Report Raises Red Flags On Medicare Lab Billing
Medicare allowed $1.7 billion in 2010 payments to clinical laboratories for claims that raised red flags, according to a report to be released Wednesday, the latest example of how the federal insurance program for the elderly and disabled is susceptible to misspending and abuse. The report, by the Department of Health and Human Services' Office of Inspector General, found that more than 1,000 laboratories showed five or more measures of questionable billing during that year, the latest available when the office began compiling the data. That includes various metrics signifying higher-than-average billing, using ineligible physician identification numbers and administering duplicate tests, among other things (Adamy, 7/9).

The Associated Press: Amedisys: SEC Ends Medicare-Related Investigation
The Securities and Exchange Commission has wrapped up an investigation into Amedisys' participation in the federal Medicare program, and no enforcement actions will be recommended, the home health care and hospice services provider says. The Baton Rouge, Louisiana, company had announced the investigation in June 2010 and said then that it also had received a Senate Finance Committee subpoena for documents. A month earlier, the Senate committee started an investigation into the billing practices of Amedisys and some other companies (7/8).

The Associated Press: Government Made $100B In Improper Payments
By its own estimate, the government made about $100 billion in payments last year to people who may not have been entitled to receive them -- tax credits to families that didn't qualify, unemployment benefits to people who had jobs and medical payments for treatments that might not have been necessary. Congressional investigators say the figure could be even higher. The Obama administration has reduced the amount of improper payments since they peaked in 2010. Still, estimates from federal agencies show that some are wasting big money at a time when Congress is squeezing agency budgets and looking to save more (Ohlemacher, 7/9).