The Centers for Medicare
& Medicaid Services (CMS) implemented the Comprehensive Error Rate
Testing (CERT) program to measure improper payments in the Medicare
Fee-for-Service (FFS) program. CERT is designed to comply with the
Improper Payments Information Act (IPIA) of 2002, as amended by the
Improper Payments Elimination and Recovery Improvement Act (IPERIA) of
2012. IPIA and IPERIA require the heads of Federal agencies, including
the Department of Health and Human Services (HHS), to annually review
programs it administers to improve agency efforts to reduce and recover
improper payments.
The Medicare FFS improper
payment rate was first measured in 1996. HHS Office of Inspector General
(OIG) was responsible for estimating the national Medicare FFS improper
payment rate from 1996 through 2002. Based on available resources, OIG
reviewed about 6,000 claims. Currently CERT selects a stratified random
sample of approximately 50,000 claims submitted to Part A/B Medicare
Administrative Contractors (MACs) and Durable Medical...
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