Medicare Part D Improper Payment Measurement
Medicare Part D Improper Payment Measurement
The Centers for Medicare & Medicaid Services (CMS) implements a systematic plan for identifying, measuring, and reporting improper Medicare Part D payments annually. Since fiscal year (FY) 2008, CMS has submitted an annual Part D improper payment estimate and the estimation methodology to Congress in the Department of Health and Human Services (HHS) Agency Financial Report (AFR). This page highlights important details about the payment error rate and offers valuable links and resources for further exploration, with accessible navigation options for all users.
Part D Payment Error Rates from FY 2016 – FY 2024
For FY 2024, CMS reported an improper payment measurement for the Part D program based on payments made during Calendar Year (CY) 2022. The Part D IPM rate for CY 2022 is 3.70%. In FY 2023, HHS implemented several methodology changes, and FY 2024 establishes a new baseline. The error rate calculation for FY 2024 follows these updated methods. While the rates for FY 2024 and FY 2023 are comparable to each other, they are not comparable to rates from previous years.
Table 1 presents results from the Part D Payment Error Estimates for FY 2024 – FY 2016.
Table 1. Part D Payment Error Estimates (FY 2024 – FY 2016)
| Reporting Year1 | Payment Year | Gross Part D Error Rate2 | Gross Dollars in Error ($B) | Net Part D Error Rate3 | Net Dollars in Error ($B) |
|---|---|---|---|---|---|
| FY 2024 | 2022 | 3.70% | $3.58 | 2.62% | $2.53 |
| FY 2023 | 2021 | 3.72% | $3.35 | 1.46% | $1.32 |
| FY 2022 | 2020 | 1.54% | $1.36 | 1.45% | $1.29 |
| FY 2021 | 2019 | 1.33% | $1.15 | 0.98% | $0.85 |
| FY 2020 | 2018 | 1.15% | $0.93 | 0.93% | $0.75 |
| FY 2019 | 2017 | 0.75% | $0.61 | 0.08% | $0.06 |
| FY 2018 | 2016 | 1.66% | $1.32 | 0.06% | $0.04 |
| FY 2017 | 2015 | 1.67% | $1.30 | -0.51% | -$0.39 |
| FY 2016 | 2014 | 3.41% | $2.39 | 1.32% | $0.93 |
1 The reporting year reports on payment year data from two years prior (e.g., FY 2024 error estimate is based on PY 2022 payments). 2 Gross payment error is calculated by taking the sum of the absolute underpayments and overpayments. 3 Net payment error is the difference between total overpayments and total absolute underpayments. | |||||
Page Last Modified:
11/18/2024 01:49 PM