In the April 17 letter, Sen. Grassley references a collaborative news article between KHN and the Center for Public Integrity. The article cites government documents showing Medicare could have overpaid five health plans $128 million in 2007. But “the Obama administration never recovered that amount and instead settled in 2012 for $3.4 million,” Sen. Grassley wrote.
Therefore, the senator called for an explanation from CMS, as “the difference in the assessment and the actual recovery is striking.” He added: “Further, in light of the $70 billion in risk score overpayments between 2008 and 2013 reported by the Center for Public Integrity, CMS’ 2007 overpayment estimate of $128 million appears low and could very well be just the tip of the iceberg.”
He said CMS must “aggressively use the tools at its disposal to ensure that it is efficiently identifying fraud and subsequently implementing timely and fair remedies.” He then posed five questions to the agency and requested a response by May 1.
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