Inappropriate Payments to Skilled Nursing Facilities Cost Medicare More Than a Billion Dollars in 2009 (OEI-02-09-00200)

November 14, 2012
The Office of Inspector General for the federal Department of Health and Human Services has identified a number of problems with billing by skilled nursing facilities (SNF), including the submission of inaccurate, medically unnecessary, and fraudulent claims. For this review, the OIG analyzed a stratified random sample of SNF claims from 2009. The OIG sought to determine if the information reported by the SNFs on the Minimum Data Set (MDS) was supported by and consistent with the medical record. The OIG found that the SNFs in the sample billed one-quarter of all claims in error in . . .