CMS Announced $15 Billion Decline in Improper FFS Payments Since 2016

November 19, 2020
Policy Snapshot

On November 16, 2020, the Centers for Medicare and Medicaid Services (CMS) announced an estimated $15 billion decline in improper Medicare fee-for-service (FFS) payments since 2016. The Medicare FFS estimated improper payment rate decreased to 6.27% in FY 2020, from 7.25% in FY 2019. CMS determined this decline was largely due to changes implemented in home health documentation requirements and changes to skilled nursing facility recertification requirements.

FY 2020 is the fourth year in a row that FFS improper payment rates have been below the 10% threshold established in statute. The agency credits its aggressive and targeted corrective actions for this continued decline in improper payments.