HealthLeaders Media June 21, 2022
The Office of Inspector General (OIG) uncovered that the program and beneficiaries could have saved $1.6 billion combined had they been charged the same payment rate as freestanding facilities.
Medicare and its beneficiaries paid considerably more at provider-based facilities than they would have for the same services at freestanding facilities, according to the OIG.
The OIG’s audit examined $3.95 billion paid for evaluation and management (E&M) services at provider-based facilities from 2010 to 2017 in eight states: California, Colorado, Florida, Louisiana, Michigan, Missouri New York, and Texas. Based on outpatient and Physician Fee Schedule (PFS) claims for E&M services performed at provider-based facilities, researchers compared the data to what would have been paid at freestanding facilities.
The cost savings potential...
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