Becker's Healthcare January 20, 2026
CMS estimated there were $28.83 billion in improper payments for Medicare fee for service in fiscal 2025. Compared to 2024 reporting, that value is down from $31.7 billion.
“While CMS’ improper payment reporting programs are designed to protect the integrity of CMS programs, improper payment measurement is not a measure of fraud, and not all improper payments are attributable to fraud or abuse,” the agency said in Jan. 15 news release. “Rather, it is important to understand that improper payments are payments that do not meet CMS program payment requirements. They can be overpayments, underpayments or payments where insufficient information was provided to determine whether a payment was proper.”
Incorrect payments sometimes result from a missed administrative step, CMS added.
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