Detecting Potential Overbilling in Medicare Reimbursement via Hours Worked
Hanming Fang () and
American Economic Review, 2017, vol. 107, issue 2, 562-91
We propose a novel and easy-to-implement approach to detect potential overbilling based on the hours worked implied by the service codes which physicians submit to Medicare. Using the Medicare Part B Fee-for-Service (FFS) Physician Utilization and Payment Data in 2012 and 2013 released by the Centers for Medicare and Medicaid Services, we construct estimates for physicians' hours spent on Medicare beneficiaries. We find that about 2,300 physicians, representing about 3 percent of those with 20 or more hours of Medicare Part B FFS services, have billed Medicare over 100 hours per week. We consider these implausibly long hours.
JEL-codes: H51 I13 I18 J22 (search for similar items in EconPapers)
Note: DOI: 10.1257/aer.20160349
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (3) Track citations by RSS feed
Downloads: (external link)
https://www.aeaweb.org/articles/attachments?retrie ... MXzE-40OgxDnmmTOIa3M (application/pdf)
https://www.aeaweb.org/articles/attachments?retrie ... wupxoXW7ItwnCLIKMTJu (application/zip)
Access to full text is restricted to AEA members and institutional subscribers.
Working Paper: Detecting Potential Overbilling in Medicare Reimbursement via Hours Worked (2016)
This item may be available elsewhere in EconPapers: Search for items with the same title.
Export reference: BibTeX
RIS (EndNote, ProCite, RefMan)
Persistent link: https://EconPapers.repec.org/RePEc:aea:aecrev:v:107:y:2017:i:2:p:562-91
Ordering information: This journal article can be ordered from
Access Statistics for this article
American Economic Review is currently edited by Esther Duflo
More articles in American Economic Review from American Economic Association Contact information at EDIRC.
Bibliographic data for series maintained by Michael P. Albert ().