The Department of Health and Human Services (HHS) Office of Inspector General (OIG) released a report in January indicating that Medicaid third party liability (TPL) savings have increased since 2001.
Specifically, state efforts have increased cost avoidance and pay-and-chase savings from $34 billion in 2001 to $72 billion in 2011. Many states attributed increased savings to the utilization of electronic systems for data matching and verification, as well as to assistance from contractors who specialize in TPL. Additionally, the OIG also reported that 44 states indicated that $4 billion are at risk, mainly in the health insurance arena, and offered the following recommendations to CMS:
- Work with states to address longstanding challenges related to identification of insurance coverage and recovery of payments;
- Address states’ challenges with one-year timely filing limits for Medicare and TRICARE; and
- Work to strengthen enforcement mechanisms designed to deal with uncooperative third parties.
Tags: cost avoidance, HHS, Medicaid, OIG, pay-and-chase, savings, States, TPL