IGF::OT::IGF THE CERT PROGRAM CALCULATES BI-ANNUAL IMPROPER PAYMENT RATES BASED ON THE RESULTS OF THE REVIEWS CONDUCTED. THESE RATES INCLUDE AN OVERALL NATIONAL MEDICARE FFS IMPROPER PAYMENT RATE AND IMPROPER PAYMENT RATES FOR EACH CLAIM TYPE [PART A INPATIENT HOSPITAL PROSPECTIVE PAYMENT SYSTEM (PPS); PART A EXCLUDING INPATIENT HOSPITAL PPS; PART B; AND DURABLE MEDICAL EQUIPMENT, PROSTHETICS, ORTHOTICS, AND SUPPLIES (DMEPOS)]. THE CERT PROGRAM ENSURES A STATISTICALLY VALID RANDOM SAMPLE; THEREFORE, THE IMPROPER PAYMENT RATE CALCULATED FROM THIS SAMPLE IS CONSIDERED TO BE REFLECTIVE OF ALL OF CLAIMS PROCESSED BY MEDICARE FFS PROGRAM DURING THE REPORT PERIOD. CMS ALSO USES THE CERT PROGRAM TO PERFORM SPECIAL STUDIES AND SUPPLEMENTAL MEASUREMENTS TO DETERMINE THE IMPROPER PAYMENT RATES OF PARTICULAR CLAIM TYPES. CALCULATIONS OF THESE RATES FACILITATE CMS ABILITY TO TAKE APPROPRIATE CORRECTIVE ACTIONS TO REDUCE IMPROPER PAYMENTS.
Verbatim from USAspending.gov. Capitalization, abbreviations, and codes are unchanged.
What the model surfaced from this award
Funds the CERT program to calculate Medicare improper payment rates and conduct statistical audits of claims.
Identifies and quantifies Medicare billing fraud and errors to enable corrective actions reducing improper payments government-wide.
Generated by award_classification v1.0.0 via claude-haiku-4-5-20251001 on 2026-05-14. Cost: $0.001369.
- Award record ingested from usaspending. Source identifier CONT_AWD_HHSM500201600081G_7530_GS00F263CA_4732.
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