That unfamiliar laboratory charge on your Medicare statement may look like something only a billing department could understand, but it deserves more than a quick glance. CMS recently announced that it revoked 157 laboratory providers from Medicare, saying the action generated $732 million in savings tied to fraudulent providers. The agency says its broader laboratory enforcement efforts have stopped more than $1.6 billion in potentially improper Medicare payments.
The $1.6 billion figure isn’t based on one enforcement action: CMS says it includes more than $500 million halted through 185 payment suspensions, more than $276 million recovered from 442 identified overpayments, and another $127 million prevented following 85 law-enforcement referrals. Some of the suspicious patterns involved tests that weren’t performed, medically unnecessary services, and laboratories billing for more expensive services than were actually provided. Here’s what every recipient needs to know about checking their Medicare statement.
