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HRD-78-172 1 (1979-02-26)

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10866g


BY THE COMPTROLLER GENERAL


Report To The Congress


OF THE UNITED STATES


Actions Needed To Stop

Excess Medicare Payments

For Blood And Blood Products



Billing and replacement practices of blood
banks and hospitals have caused substantial
Medicare overpayments for blood and blood
products.


Blood banks have prevented
blood replacement credits to
fees whenever Medicare would


the use of
reduce blood
pay the fees.


Hospitals have not followed other Medicare
billing instructions, further inflating Medicare
charges for blood. Monitoring by the Depart-
ment of Health, Education, and Welfare and
its authorized intermediaries--such organiza-
tions as insurance companies authorized to
pay for services--has been inadequate to
identify and correct these problems.

This report recommends that the Secretary
of Health, Education, and Welfare direct the
Administrator, Health Care Financing Ad-
ministration, to clarify Medicare blood bill-
ing instructions, improve monitoring of
blood bank replacement and hospital billing
practices, and initiate appropriate recovery
actions.


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     HRD-78-172
FEBRUARY 26, 1979


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