$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
Audits Medicare claims to calculate improper payment rates and identify fraud across hospital, physician, and equipment services.
Reduces Medicare waste and fraud through statistically valid sampling; enables corrective actions protecting program integrity and taxpayer funds.
Signals increased scrutiny of healthcare provider billing practices, affecting compliance costs for hospitals, physicians, and medical equipment suppliers.
Generated by award_classification v2.0.0 via claude-haiku-4-5-20251001 on 2026-05-15. Cost: $0.002325.
- 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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