High Risk Series:

Medicare Claims

HR-93-6: Published: Dec 1, 1992. Publicly Released: Dec 1, 1992.

Additional Materials:

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GAO provided information on the Health Care Financing Administration's (HCFA) management of the Medicare Program and whether insufficient funding exposes the program to unnecessary loss through waste, fraud, and abuse.

GAO found that: (1) Medicare losses resulting from fraud, waste, and abuse could total 10 percent of the nation's total health care costs; (2) HCFA relies on contractors to process Medicare claims and protect program funds with payment safeguards; (3) HCFA failure to properly manage contractors' safeguards and insufficient funding exposed the program to waste, fraud, and abuse; (4) HCFA contractors often failed to investigate fraud complaints raised by Medicare beneficiaries and failed to recover $170 million in overpayments from hospitals; (5) HCFA contractors paid nearly $2 billion in claims for which other insurers were responsible; and (6) HCFA needs to strengthen contractor oversight, reduce excessive payments, and tighten billing controls.

Below are the reports in this series:

High Risk Series: Farmers Home Administration's Farm Loan Programs HR-93-1, Dec 1, 1992

High Risk Series: Guaranteed Student Loans HR-93-2, Dec 1, 1992

High Risk Series: Bank Insurance Fund HR-93-3, Dec 1, 1992

High Risk Series: Resolution Trust Corporation HR-93-4, Dec 1, 1992

High Risk Series: Pension Benefit Guaranty Corporation HR-93-5, Dec 1, 1992

High Risk Series: Medicare Claims HR-93-6, Dec 1, 1992

High Risk Series: Defense Weapons Systems Acquisition HR-93-7, Dec 1, 1992

High Risk Series: Defense Contract Pricing HR-93-8, Dec 1, 1992

High Risk Series: Department of Energy Contract Management HR-93-9, Dec 1, 1992

High Risk Series: Superfund Program Management HR-93-10, Dec 1, 1992

High Risk Series: NASA Contract Management HR-93-11, Dec 1, 1992

High Risk Series: Defense Inventory Management HR-93-12, Dec 1, 1992

High Risk Series: Internal Revenue Service Receivables HR-93-13, Dec 1, 1992

High Risk Series: Managing the Customs Service HR-93-14, Dec 1, 1992

High Risk Series: Management of Overseas Real Property HR-93-15, Dec 1, 1992

High Risk Series: Federal Transit Administration Grant Management HR-93-16, Dec 1, 1992

High Risk Series: Asset Forfeiture Programs HR-93-17, Dec 1, 1992

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