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Medicare Fraud Further Actions Needed To Address Fraud Waste And Abuse
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Book Synopsis Medicare Fraud by : Kathleen M. King
Download or read book Medicare Fraud written by Kathleen M. King and published by CreateSpace. This book was released on 2014-07-25 with total page 26 pages. Available in PDF, EPUB and Kindle. Book excerpt: GAO has designated Medicare as a high-risk program, in part because the program's size and complexity make it vulnerable to fraud, waste, and abuse. In 2013, Medicare financed health care services for approximately 51 million individuals at a cost of about $604 billion. The deceptive nature of fraud makes its extent in the Medicare program difficult to measure in a reliable way, but it is clear that fraud contributes to Medicare's fiscal problems. More broadly, in fiscal year 2013, Centers for Medicare & Medicaid Services (CMS) estimated that improper payments—some of which may be fraudulent—were almost $50 billion.
Author :United States Government Accountability Office Publisher :Createspace Independent Publishing Platform ISBN 13 :9781981886562 Total Pages :26 pages Book Rating :4.8/5 (865 download)
Book Synopsis Medicare Fraud by : United States Government Accountability Office
Download or read book Medicare Fraud written by United States Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-12-21 with total page 26 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare Fraud: Further Actions Needed to Address Fraud, Waste, and Abuse
Book Synopsis Medicare Fraud - Further Actions Needed to Address Fraud, Waste, and Abuse by : U.s. Government Accountability Office
Download or read book Medicare Fraud - Further Actions Needed to Address Fraud, Waste, and Abuse written by U.s. Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-07-27 with total page 26 pages. Available in PDF, EPUB and Kindle. Book excerpt: " GAO has designated Medicare as a high-risk program, in part because the program's size and complexity make it vulnerable to fraud, waste, and abuse. In 2013, Medicare financed health care services for approximately 51 million individuals at a cost of about $604 billion. The deceptive nature of fraud makes its extent in the Medicare program difficult to measure in a reliable way, but it is clear that fraud contributes to Medicare's fiscal problems. More broadly, in fiscal year 2013, CMS estimated that improper payments-some of which may be fraudulent-were almost $50 billion. This statement focuses on the progress made and important steps to be taken by CMS and its program integrity contractors to reduce fraud in Medicare. This statement is based on relevant GAO products and recommendations issued from 2004 through 2014 using a variety of methodologies. Additionally, in June 2014, GAO updated information based on new regulations regarding enrollment of certain providers in Medicare by examining public documents.
Author :United States Government Accountability Office Publisher :Createspace Independent Publishing Platform ISBN 13 :9781981886616 Total Pages :26 pages Book Rating :4.8/5 (866 download)
Book Synopsis Medicare Fraud by : United States Government Accountability Office
Download or read book Medicare Fraud written by United States Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-12-21 with total page 26 pages. Available in PDF, EPUB and Kindle. Book excerpt: MEDICARE FRAUD: Progress Made, but More Action Needed to Address Medicare Fraud, Waste, and Abuse
Book Synopsis Medicare Fraud, Progress Made, But More Action Needed to Address Medicare Fraud, Waste and Abuse by : U.s. Government Accountability Office
Download or read book Medicare Fraud, Progress Made, But More Action Needed to Address Medicare Fraud, Waste and Abuse written by U.s. Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-07-27 with total page 26 pages. Available in PDF, EPUB and Kindle. Book excerpt: " GAO has designated Medicare as a high-risk program, in part because the program's size and complexity make it vulnerable to fraud, waste, and abuse. In 2013, Medicare financed health care services for approximately 51 million individuals at a cost of about $604 billion. The deceptive nature of fraud makes its extent in the Medicare program difficult to measure in a reliable way, but it is clear that fraud contributes to Medicare's fiscal problems. More broadly, in fiscal year 2013, CMS estimated that improper payments-some of which may be fraudulent-were almost $50 billion. This statement focuses on the progress made and important steps to be taken by CMS and its program integrity contractors to reduce fraud in Medicare. These contractors perform functions such as screening and enrolling providers, detecting and investigating potential fraud, and identifying improper payments and vulnerabilities that could lead to payment errors. This statement is based on relevant GAO products and recommendations issued from 2004 through 2014 using a variety of methodologies. In April 2014, GAO also received updated information from CMS on its actions related to the laws, regulations, and guidance discussed in this statement. Additionally, GAO updated information by examining public documents and relevant policies"
Author :United States. Congress. House. Committee on Ways and Means. Subcommittee on Health Publisher : ISBN 13 : Total Pages :120 pages Book Rating :4.:/5 (327 download)
Book Synopsis Medicare Fraud, Waste, and Abuse by : United States. Congress. House. Committee on Ways and Means. Subcommittee on Health
Download or read book Medicare Fraud, Waste, and Abuse written by United States. Congress. House. Committee on Ways and Means. Subcommittee on Health and published by . This book was released on 1992 with total page 120 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Medicare Fraud, Waste, and Abuse: Challenges and Strategies for Preventing Improper Payments by : Kathleen M. King
Download or read book Medicare Fraud, Waste, and Abuse: Challenges and Strategies for Preventing Improper Payments written by Kathleen M. King and published by DIANE Publishing. This book was released on 2010-10 with total page 15 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare¿s size and complexity make it vulnerable to fraud, waste, and abuse. Fraud represents intentional acts of deception with knowledge that the action or representation could result in an inappropriate gain, while abuse represents actions inconsistent with acceptable bus. or med. practices. Waste, which includes inaccurate payments for services, also occurs in the Medicare program. In 2009, the Centers for Medicare and Medicaid Services (CMS) estimated billions of dollars in improper payments in the Medicare program. This statement focuses on challenges facing CMS and selected key strategies that are particularly important to helping prevent fraud, waste, and abuse, and ultimately to reducing improper payments. Illustrations.
Book Synopsis Medicare and Medicaid Fraud,Waste, and Abuse by :
Download or read book Medicare and Medicaid Fraud,Waste, and Abuse written by and published by DIANE Publishing. This book was released on with total page 31 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Medicare and Medicaid fraud, waste, and abuse by : Kathleen M. King
Download or read book Medicare and Medicaid fraud, waste, and abuse written by Kathleen M. King and published by . This book was released on 2011 with total page 27 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Medicare and Medicaid Fraud, Waste, and Abuse by : Government Accountability Office
Download or read book Medicare and Medicaid Fraud, Waste, and Abuse written by Government Accountability Office and published by . This book was released on 2017-08-17 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt: "GAO has designated Medicare and Medicaid as high-risk programs because they are particularly vulnerable to fraud, waste, abuse, and improper payments (payments that should not have been made or were made in an incorrect amount). Medicare is considered high-risk in part because of its complexity and susceptibility to improper payments, and Medicaid because of concerns about the adequacy of its fiscal oversight to prevent inappropriate spending.In fiscal year 2010, the Centers for Medicare & Medicaid Services (CMS)-the agency that administers Medicare and Medicaid-estimated that these programs made a total of over $70 billion in improper payments.This statement focuses on how implementing prior GAO recommendations and recent laws, as well as other agency actions, could help CMS carry out five key strategies GAO identified in previous reports to help reduce fraud, waste, and abuse and improper payments in Medicare and Medicaid. It is based on 16 GAO products issued from April 2004 through June 2010 using a variety of methodologies, such as analyses of Medicare or Medicaid claims, review of relevant policies and procedures, and interviews with officials. In February 2011, GAO also received updated information from CMS..."
Book Synopsis Health Care Fraud and Abuse by : Aspen Health Law Center
Download or read book Health Care Fraud and Abuse written by Aspen Health Law Center and published by . This book was released on 1998 with total page 156 pages. Available in PDF, EPUB and Kindle. Book excerpt: Stepped-up efforts to ferret out health care fraud have put every provider on the alert. The HHS, DOJ, state Medicaid Fraud Control Units, even the FBI is on the case -- and providers are in the hot seat! in this timely volume, you'll learn about the types of provider activities that fall under federal fraud and abuse prohibitions as defined in the Medicaid statute and Stark legislation. And you'll discover what goes into an effective corporate compliance program. With a growing number of restrictions, it's critical to know how you can and cannot conduct business and structure your relationships -- and what the consequences will be if you don't comply.
Book Synopsis Fraud detection systems by : Joel C. Willemssen
Download or read book Fraud detection systems written by Joel C. Willemssen and published by . This book was released on 2011 with total page 11 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Medicare Program Integrity by : Kathleen M. King
Download or read book Medicare Program Integrity written by Kathleen M. King and published by . This book was released on 2015-01-01 with total page 39 pages. Available in PDF, EPUB and Kindle. Book excerpt: Recent media reports and law enforcement actions have highlighted the problem of prescription drug fraud, waste, and abuse in the U.S. Medicare, and the Part D prescription drug benefit, are susceptible to such fraud -- a risk made greater by Medicare's size, scope, and complexity. Questions have been raised about the Department of Health and Human Services' (HHS) Centers for Medicare & Medicaid Services' (CMS's) oversight of its activities to address fraud, waste, and abuse in Part D, as well as oversight of the contractors tasked with this work. This report examined: (1) practices for promoting prescription drug program integrity; and (2) the extent that CMS's oversight of Medicare Part D program integrity, including the program integrity contractors, reflects these practices. Tables and figures. This is a print on demand report.
Author :United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Oversight and Investigations Publisher : ISBN 13 : Total Pages :164 pages Book Rating :4.F/5 ( download)
Book Synopsis Medicare Program Integrity by : United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Oversight and Investigations
Download or read book Medicare Program Integrity written by United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Oversight and Investigations and published by . This book was released on 2015 with total page 164 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Program Integrity by : U.s. Government Accountability Office
Download or read book Program Integrity written by U.s. Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-08-05 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt: " In 2011, CMS estimated that Medicaid and Medicare had improper payments of $21.9 billion and almost $43 billion, respectively-among the largest for all federal programs. Both health care programs are on GAO's list of high-risk programs. Over the years, Congress has passed legislation designed to help address program integrity issues in the two programs but they remain vulnerable to fraud, waste, and abuse. The program integrity challenges are different for Medicaid and Medicare. With 51 distinct state-based programs, Medicaid has complex challenges for finding the appropriate balance between state and federal efforts. Medicare uses contractors to help administer the program and CMS must oversee their efforts. This statement examines the progress made and important steps still to be taken in these programs. GAO focused on four key strategies and recommendations that were designed to facilitate them that were identified in prior work and that could help reduce improper payments: (1) strengthening provider enrollment standards and procedures to ensure that only legitimate providers participate in the program; (2) improving prepayment controls; (3) improving postpayment claims review and recovery of improper payments; and (4) developing a robust process for addressing identified vulnerabilities. This statement is based on GAO products issued from April 2004 through May 2012 and interviews with agency officials and other stakeholders. In May 2012, GAO"
Book Synopsis Standards for Internal Control in the Federal Government by : United States Government Accountability Office
Download or read book Standards for Internal Control in the Federal Government written by United States Government Accountability Office and published by Lulu.com. This book was released on 2019-03-24 with total page 88 pages. Available in PDF, EPUB and Kindle. Book excerpt: Policymakers and program managers are continually seeking ways to improve accountability in achieving an entity's mission. A key factor in improving accountability in achieving an entity's mission is to implement an effective internal control system. An effective internal control system helps an entity adapt to shifting environments, evolving demands, changing risks, and new priorities. As programs change and entities strive to improve operational processes and implement new technology, management continually evaluates its internal control system so that it is effective and updated when necessary. Section 3512 (c) and (d) of Title 31 of the United States Code (commonly known as the Federal Managers? Financial Integrity Act (FMFIA)) requires the Comptroller General to issue standards for internal control in the federal government.
Book Synopsis Healthcare Fraud by : Rebecca S. Busch
Download or read book Healthcare Fraud written by Rebecca S. Busch and published by John Wiley & Sons. This book was released on 2012-05-01 with total page 374 pages. Available in PDF, EPUB and Kindle. Book excerpt: An invaluable tool equipping healthcare professionals, auditors, and investigators to detect every kind of healthcare fraud According to private and public estimates, billions of dollars are lost per hour to healthcare waste, fraud, and abuse. A must-have reference for auditors, fraud investigators, and healthcare managers, Healthcare Fraud, Second Edition provides tips and techniques to help you spot—and prevent—the "red flags" of fraudulent activity within your organization. Eminently readable, it is your "go-to" resource, equipping you with the necessary skills to look for and deal with potential fraudulent situations. Includes new chapters on primary healthcare, secondary healthcare, information/data management and privacy, damages/risk management, and transparency Offers comprehensive guidance on auditing and fraud detection for healthcare providers and company healthcare plans Examines the necessary background that internal auditors should have when auditing healthcare activities Managing the risks in healthcare fraud requires an understanding of how the healthcare system works and where the key risk areas are. With health records now all being converted to electronic form, the key risk areas and audit process are changing. Read Healthcare Fraud, Second Edition and get the valuable guidance you need to help combat this critical problem.
