How many percent of Medicare payments are audited?

• A. 1%
• B. 5%
• C. 10%
• D. 2%

Answer: (A)

The correct answer is that typically about 1% of Medicare payments are audited. This percentage stems from the Medicare program's practices around utilization review and fraud detection. The audits are essential for ensuring that claims are valid and in compliance with Medicare regulations. While audits are a necessary part of maintaining program integrity, the relatively small percentage reflects the vast scale of Medicare operations, which processes millions of claims daily.

Auditing a larger percentage could be cost-prohibitive and logistically challenging, given the volume of claims. Therefore, conducting audits on about 1% allows for a balance between oversight and operational efficiency, ensuring that resources can be allocated effectively without overwhelming the system.