All Agencies (A-Z) » Offices, Department of Health and Human Services, Executive » Department of Justice, Executive
Department of Justice, Executive (11 - 20 of 25 items)
Protection and Advocacy Agencies: Involvement in Deinstitutionalization Lawsuits on Behalf of Individuals with Developmental Disabilities
GAO-03-1044: Published: Sep 30, 2003. Publicly Released: Oct 30, 2003.
Congress established the Protection and Advocacy system in 1975 to protect the rights of individuals with developmental disabilities, most of whom have mental retardation. Protection and Advocacy agencies (P&A) use investigative and legal activities to advocate on behalf of these individuals. Deinstitutionalization has refocused delivery of care to this population over the last several decades fro...
Medicare: Health Care Fraud and Abuse Control Program for Fiscal Years 2000 and 2001
GAO-02-731: Published: Jun 3, 2002. Publicly Released: Jun 3, 2002.
The Medicare program is the nation's largest health insurer with almost 40 million beneficiaries and outlays of over $219 billion annually. Because of the susceptibility of the program to fraud and abuse, Congress enacted the Health Care Fraud and Abuse Control (HCFAC) Program as part of the Health Insurance Portability and Accountability Act (HIPPAA) of 1996. HCFAC, which is administered by the D...
Medicare Management: CMS Faces Challenges to Sustain Progress and Address Weaknesses
GAO-01-817: Published: Jul 31, 2001. Publicly Released: Aug 31, 2001.
Considering the complexity, the size, and the statutory constraints affecting the Medicare Program, some contend that the Health Care Financing Administration's (HCFA)--recently renamed the Centers for Medicare and Medicaid Services--management of Medicare has, on balance, been satisfactory. Others argue that HCFA's management has been unacceptable. HCFA's record has been mixed and the agency's ch...
Medicaid: State Efforts to Control Improper Payments Vary
GAO-01-662: Published: Jun 7, 2001. Publicly Released: Jul 10, 2001.
State Medicaid programs make a wide variety of payments to individuals, institutions, and managed health care plans for services provided to beneficiaries whose eligibility status may fluctuate because of changes in income. Because of the size and the nature of the program, Medicaid is potentially at risk for billions of dollars in improper payments. The exact amount is unknown because few states...
Medicare: Health Care Fraud and Abuse Control Program Financial Reports for Fiscal Years 1998 and 1999
AIMD-00-257R: Published: Jul 31, 2000. Publicly Released: Jul 31, 2000.
Pursuant to a legislative requirement, GAO reviewed the Health Care Fraud and Abuse Control (HCFAC) Program financial reports for fiscal years (FY) 1998 and 1999 as required by the the Health Insurance Portability and Accountability Act (HIPAA) of 1996.GAO noted that: (1) the Department of Health and Human Services (HHS) and the Department of Justice (DOJ) joint HCFAC reports for fiscal years 1998...
Medicare: Improprieties by Contractors Compromised Medicare Program Integrity
OSI-99-7: Published: Jul 14, 1999. Publicly Released: Jul 14, 1999.
Pursuant to a congressional request, GAO determined whether Medicare contractors participated in any improper or questionable practices that contributed to fraud, waste, or abuse in the Medicare federal health insurance program, focusing on: (1) recently completed cases of criminal conduct or False Claims Act violations committed by Medicare contractors; (2) the deceptive contractor activities set...
Medicare: Early Evidence of Compliance Program Effectiveness Is Inconclusive
HEHS-99-59: Published: Apr 15, 1999. Publicly Released: Apr 15, 1999.
Pursuant to a congressional request, GAO reviewed the compliance programs established by health care providers to reduce improper payments by Medicare, focusing on the: (1) prevalence of compliance programs among hospitals and other Medicare providers; (2) costs involved with compliance programs; and (3) effectiveness of the programs, to the extent that could be measured.GAO noted that: (1) althou...
Major Management Challenges and Program Risks: Department of Health and Human Services
OCG-99-7: Published: Jan 1, 1999. Publicly Released: Jan 1, 1999.
As part of its Performance and Accountability Series, GAO provided information on the major management challenges and program risks facing the Department of Health and Human Services (HHS).GAO noted that: (1) coordinating the efforts of the numerous administrators of HHS' programs, including its 11 agencies and state and local governments, is critical to ensuring program efficiency and effectivene...
Use of False Claims Act for Medicare Outpatient Claims Cases
B-279893: Published: Jul 22, 1998. Publicly Released: Aug 26, 1998.
Pursuant to a congressional request, GAO addressed a number of issues concerning the Department of Health and Human Services' (HHS) and the Department of Justice's (DOJ) enforcement of the False Claims Act against hospitals submitting improper Medicare claims for outpatient services. GAO held that: (1) there was no evidence that errors hospitals made with respect to HHS' and DOJ's 72-hour rule wer...
Medicare: Application of the False Claims Act to Hospital Billing Practices
HEHS-98-195: Published: Jul 10, 1998. Publicly Released: Aug 10, 1998.
Pursuant to a congressional request, GAO reviewed: (1) the False Claims Act and its application to claims involving health care programs; (2) information on the data sources, analysis, and procedures used to bring False Claims Act cases against hospitals under the 72-Hour Window Project; and (3) similar information on the Lab Unbundling Project.GAO noted that: (1) the False Claims Act was original...