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HRD-83-43 1 (1983-02-22)

handle is hein.gao/gaobabnbb0001 and id is 1 raw text is: 21~ Ms. Barbara Cagel Regional Administrator Health Care Financing Administration Region V 175 West Jackson Boulevard Suite A-835 Chicago, Illinois 60604 121980 21111 Dear Ms. Gagel: Subject: Review of Medicare and Medicaia Duplicate Payments in Michigan (GAO/HRD-83-43) As part of our continuing review of medical payments under the Medicare and Medicaid programs, we reviewed the practices and procedures used by the Michigan Medicare carrier (Blue Cross/Blue Shield of Michigan) and Medicaid administrator (State of Michigan Medical !ervices Administration) to prevent duplicate payments to physizians with more than one provider identification number. We also reviewed the practices and procedures they used to remove unlicensed physicians from the Medicare and Medicaid rolls. We found that: --Duplicate payments of $39,023 (actual) and $14,549 (estimated) were made to Medicare providers having multiple provider numbers. --Duplicate payments of $24,893 were made to Medicaid providers having multiple provider numbers. --Estimated overpayments of $74,850 were made to surgical assistants and anesthesiologists for Medicare covered services. --Improper payments of $13,000 were made to unlicensed physicians for Medicare covered services. According to the carrier's and the State's payments records, few of these erroneous payments had been voluntarily returned by the providers or Medicare beneficiaries or otherwise recovered. (106225) S r RAL Ac K. b) RiGIONAL OFFICE ROOM a8d s. rAT RICK V. McNAMAMA FLD -AL VUILDINC 477 MJCHGAN AVENUE DETROIT, MICHIGAN 48.26 February 22, 1983

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