Fraud, Abuse and Overpayments in the Medicare and Medicaid Programs

Fraud, Abuse and Overpayments in the Medicare and Medicaid Programs

Author: Bentley Orr

Publisher: Nova Snova

Published: 2020-03-03

Total Pages: 269

ISBN-13: 9781536173727

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Chapter 1 focuses on how the Centers for Medicare and Medicaid Services (CMS) identifies and combats waste, fraud, and abuse in both traditional Medicare and the Medicare Advantage program. Reducing improper payments is critical for protecting the integrity of the program and ensuring that taxpayer dollars are well spent. The Medicaid program, which provides vital health care to over 70 million Americans, regardless of preexisting conditions. GAO and the Department of Health and Human Services (HHS) Office of Inspector General (OIG) published reports on continued weaknesses and program integrity risks and Medicaid managed care. Clearly, there is a need for greater transparency on how managed care organizations spend Federal dollars and greater program integrity and oversight in Medicaid in general. Chapter 2 talks about the rate of improper payments in the Medicaid program.


Medicare Fraud, Waste, and Abuse: Challenges and Strategies for Preventing Improper Payments

Medicare Fraud, Waste, and Abuse: Challenges and Strategies for Preventing Improper Payments

Author: Kathleen M. King

Publisher: DIANE Publishing

Published: 2010-10

Total Pages: 15

ISBN-13: 1437935001

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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.


Medicare Program Integrity

Medicare Program Integrity

Author: United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Oversight and Investigations

Publisher:

Published: 2015

Total Pages: 164

ISBN-13:

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Medicaid

Medicaid

Author: United States. General Accounting Office

Publisher:

Published: 2001

Total Pages: 76

ISBN-13:

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