$206,694,861
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
Ongoing contract to calculate Medicare improper payment rates and conduct claims audits across hospital, physician, and equipment services.
The CERT program identifies and quantifies Medicare billing errors and fraud, enabling CMS to recover billions in improper payments and strengthen program integrity.
Generated by award_classification v2.1.0 via claude-haiku-4-5-20251001 on 2026-05-21. Cost: $0.002988.
- USAspending.gov — all awards for this UEI →
- SAM.gov entity registration →
- Award record ingested from usaspending. Source identifier CONT_AWD_HHSM500201600081G_7530_GS00F263CA_4732.
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