dr. mcdermott, members of the committee, thank you very much for this opportunity to testify before you today. i'm dr. ellen evans, lead physician with health data insight, cms recovery auditor. i am a proud graduate of the university of texas medical school, residency-trained, board-certified licensed family physician with a certificate of added qualifications in geriatric medicine. i joined hgi during the rac demonstration program. at hdi i oversee all of our medical and clinical recovery audit activities. the recovery audit program is not focused on fraudulent payments. we review claims to insure compliance with medicare practices and also identify underpayments that are returned to the providers. this program is a critical component of medicare operations because over $30 billion are improperly paid by medicare every year. since the recovery audit program was passed and implemented in 2006, over 8 billion improperly paid medicare dollars have been recovered as well as $700 million in under payments returned to providers. recovery auditors identify types of claims most at risk of improper

dr. mcdermott for five mints. >> thank you, mr. chairman. from a patient standpoint you walk into the emergency room or whatever, and you get put in one of these statuses or the other. does it make any difference to the patient to the by-we, which status they're put? as to how they're treated? >> as to how they're treated front a benefit perspective? >> i'm talking how they're treated as a patient. i would hope not. >> i would hope not. i hope patients receive all treatments medically needed. >> so the difference is in the payments that is received by the hospital or that the patient has to make depending on which category their in. is that correct? >> certainly the statute creates a stark difference between inpatient and outpatient care. >> give us the amount of difference for a hospital, what they receive and what the patient has to pay? so we get some idea who is bearing the weight here. >> these will be -- the amounts both that the hospital receives and the beneficiary would be liable for would very tremendously on individual circumstanc