Health Care:

Consultants' Billing Advice May Lead to Improperly Paid Insurance Claims

GAO-01-818: Published: Jun 27, 2001. Publicly Released: Jun 27, 2001.

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Donald G. Fulwider
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This report investigates health care consultants who conduct seminars or workshops that offer advice to health care providers on ways to enhance revenue and avoid audits or investigations. GAO attended several seminars and workshops offered by these consultants. GAO sought to determine whether the consultants were providing advice that could result in improper or excessive claims to Medicare, Medicaid, other federally funded health plans, and private health insurance carriers. GAO found that some advice was inconsistent with guidance provided by the Department of Health and Human Services' Office of Inspector General (OIG). Such advice could result in violations of both civil and criminal statutes.

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