Review of Medicare and Medicaid Duplicate Payments in Michigan

Gao ID: HRD-83-43 February 22, 1983

GAO reviewed the practices and procedures of the Michigan Medicare carrier and Medicaid administrator to prevent duplicate payments to physicians with more than one provider identification number and to remove unlicensed physicians from the Medicare and Medicaid rolls.

GAO found that: (1) duplicate payments of about $39,000 were made to Medicare providers with multiple-provider numbers; (2) duplicate payments of about $24,900 were made to Medicaid providers with multiple-provider numbers; (3) estimated overpayments of about $74,850 were made to surgical assistants and anesthesiologists for Medicare-covered services; and (4) improper payments of about $13,000 were made to unlicensed physicians for Medicare-covered services. GAO also found that few erroneous payments were voluntarily returned by providers or beneficiaries, or otherwise recovered. GAO noted that the State is redesigning its enrollment system to implement a single-provider-number system to eliminate duplicate billings.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

Director: Michael Zimmerman Team: General Accounting Office: Human Resources Division Phone: (202) 275-6195


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