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Medicare : Important Steps Have Been Taken, But More Could Be Done to Deter Fraud: Gao-12-671t pdf

Medicare : Important Steps Have Been Taken, But More Could Be Done to Deter Fraud: Gao-12-671t pdf

Medicare : Important Steps Have Been Taken, But More Could Be Done to Deter Fraud: Gao-12-671t by U S Government Accountability Office (G

Medicare : Important Steps Have Been Taken, But More Could Be Done to Deter Fraud: Gao-12-671t
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Author: U S Government Accountability Office (G
Number of Pages: 28 pages
Published Date: 16 May 2013
Publisher: Bibliogov
Publication Country: United States
Language: English
ISBN: 9781287206828
File size: 22 Mb
File Name: Medicare.Important.Steps.Have.Been.Taken,.But.More.Could.Be.Done.to.Deter.Fraud.Gao-12-671t.pdf
Download Link: Medicare Important Steps Have Been Taken, But More Could Be Done to Deter Fraud Gao-12-671t
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The Centers for Medicare & Medicaid Services (CMS)-the agency that administers Medicare-has made progress in implementing several key strategies GAO identified in prior work as helpful in protecting Medicare from fraud; however, some actions that could help combat fraud remain incomplete. Provider Enrollment: GAO's previous work found persistent weaknesses in Medicare's enrollment standards and procedures that increased the risk of enrolling entities intent on defrauding the program. CMS has strengthened provider enrollment-for example, in February 2011, CMS designated three levels of risk-high, moderate, and limited-with different screening procedures for categories of providers at each level. However, CMS has not completed other actions, including implementation of some relevant provisions of the Patient Protection and Affordable Care Act (PPACA). Specifically, CMS has not (1) determined which providers will be required to post surety bonds to help ensure that payments made for fraudulent billing can be recovered, (2) contracted for fingerprint-based criminal background checks, (3) issued a final regulation to require additional provider disclosures of information, and (4) established core elements for provider compliance programs.

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