Preventing Abusive Medicare Billing
HEHS-95-260R: Published: Sep 5, 1995. Publicly Released: Sep 5, 1995.
Additional Materials:
- Full Report:
Contact:
Pursuant to a congressional request, GAO discussed its recommendations for preventing abusive Medicare billing and whether the recommendations can be implemented legislatively. GAO noted that: (1) Medicare law could be amended to require the Department of Health and Human Services (HHS) to establish the requirements recommended, as well as establish a higher limit on the amount that Medicare will recognize as reasonable for therapy services; (2) expense claim limits could be set at the amount established under Medicare's part B fee schedules for therapy services; (3) establishing an upper limit would partially define billable units of service, since the procedure codes for occupational and speech therapy do not define the amount of time the codes cover; and (5) proposals have been made to require nursing homes to bill for the services provided to their residents, whether payment is sought from part A or part B fee schedules.
Jan 21, 2021
Rural Hospital Closures:
Affected Residents Had Reduced Access to Health Care ServicesGAO-21-93: Published: Dec 22, 2020. Publicly Released: Jan 21, 2021.-
Health Care Funding:
Federal Obligations to and Funds Received by Certain Organizations Involved in Health-Related Services, 2016 through 2018GAO-21-188R: Published: Dec 21, 2020. Publicly Released: Jan 21, 2021.
Jan 14, 2021
-
Medicaid:
Data Completeness and Accuracy Have Improved, Though Not All Standards Have Been MetGAO-21-196: Published: Jan 14, 2021. Publicly Released: Jan 14, 2021.
Jan 4, 2021
-
Medicare Severe Wound Care:
Spending Declines May Reflect Site of Care Changes; Limited Information Is Available on QualityGAO-21-92: Published: Jan 4, 2021. Publicly Released: Jan 4, 2021.
Dec 22, 2020
-
Defense Health Care:
Efforts to Ensure Beneficiaries Access Specialty Care and Receive Timely and Effective CareGAO-21-143: Published: Dec 22, 2020. Publicly Released: Dec 22, 2020.
Dec 16, 2020
-
Medicaid Long-Term Services and Supports:
Access and Quality Problems in Managed Care Demand Improved OversightGAO-21-49: Published: Nov 16, 2020. Publicly Released: Dec 16, 2020.
Dec 14, 2020
-
Drug Pricing Program:
HHS Uses Multiple Mechanisms to Help Ensure Compliance with 340B RequirementsGAO-21-107: Published: Dec 14, 2020. Publicly Released: Dec 14, 2020. -
Substance Use Disorder:
Reliable Data Needed for Substance Abuse Prevention and Treatment Block Grant ProgramGAO-21-58: Published: Dec 14, 2020. Publicly Released: Dec 14, 2020.
Dec 10, 2020
-
Indian Health Service:
Actions Needed to Improve Oversight of Provider Misconduct and Substandard PerformanceGAO-21-97: Published: Dec 10, 2020. Publicly Released: Dec 10, 2020. -
Clinical Labs:
Studies Suggest Biopsy Specimen Misidentification and Contamination Errors Are InfrequentGAO-21-59: Published: Nov 10, 2020. Publicly Released: Dec 10, 2020.
Looking for more? Browse all our products here
Explore our Key Issues on Health Care
- Air Quality
- Border Security and Immigration
- Children's Health and Safety
- Drug Misuse
- Elder Abuse
- Health Care Quality
- Health Information Technology
- Improper Payments
- Improving Federal Programs that Serve Tribes and Their Members - High Risk Issue
- Managing Risks and Improving VA Health Care
- Medicaid - High Risk Issue
- Medical Product Oversight - High Risk Issue
- Medicare - High Risk Issue
- Prescription Drug Spending
- Supports and Services for Transitioning Veterans
- Toxic Chemicals - High Risk Issue
- Tribal and Native American Issues
- VA and DOD Health Care Management
- VA and DOD Patient Care
- Women and Gender in Public Policy
Explore our other Key Issues here
