Reviews of Clinicians Associated With High Cumulative Payments Could Improve Medicare Program Integrity Efforts (A-01-11-00511)

December 15, 2013 Reviews of Clinicians Associated With High Cumulative Payments Could Improve Medicare Program Integrity Efforts (A-01-11-00511) The Office of the Inspector General for the federal Department of Health and Human Services sought to determine how many individual clinicians who were responsible for high cumulative payments were reviewed by Medicare administrative contactors (MACs) or Zone Program Integrity Contractors (ZPICs) to identify improper payments. The OIG also analyzed the outcomes of those reviews. Medicare paid more than $65 billion for Part B services in each calendar year from 2008 through 2011. In each of these four years . . .