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.
May 22, 2019
Children Affected by Trauma:
Selected States Report Various Approaches and Challenges to Supporting ChildrenGAO-19-388: Published: Apr 24, 2019. Publicly Released: May 22, 2019.
May 20, 2019
-
Prescription Opioids:
Voluntary Medicare Drug Management Programs to Control MisuseGAO-19-446: Published: May 20, 2019. Publicly Released: May 20, 2019.
May 17, 2019
-
Medicaid Demonstrations:
Approvals of Major Changes Need Increased TransparencyGAO-19-315: Published: Apr 17, 2019. Publicly Released: May 17, 2019.
Apr 15, 2019
-
Management Report:
CMS Needs to Address Gaps in Federal Oversight of Nursing Home Abuse Investigations That Persisted in Oregon for at Least 15 YearsGAO-19-313R: Published: Apr 15, 2019. Publicly Released: Apr 15, 2019.
Apr 10, 2019
-
Veterans Health Care:
VA Needs to Address Challenges as It Implements the Veterans Community Care ProgramGAO-19-507T: Published: Apr 10, 2019. Publicly Released: Apr 10, 2019.
Apr 8, 2019
-
Priority Open Recommendations:
Department of Health and Human ServicesGAO-19-364SP: Published: Mar 28, 2019. Publicly Released: Apr 8, 2019.
Apr 1, 2019
-
Behavioral Health:
Research on Health Care Costs of Untreated Conditions is LimitedGAO-19-274: Published: Feb 28, 2019. Publicly Released: Apr 1, 2019.
Mar 28, 2019
-
Defense Health Care:
DOD's Proposed Plan for Oversight of Graduate Medical Education ProgramsGAO-19-338: Published: Mar 28, 2019. Publicly Released: Mar 28, 2019.
Mar 27, 2019
-
Medicare and Medicaid:
CMS Should Assess Documentation Necessary to Identify Improper PaymentsGAO-19-277: Published: Mar 27, 2019. Publicly Released: Mar 27, 2019.
Mar 21, 2019
-
Private Health Insurance:
Enrollment Remains Concentrated among Few Issuers, including in ExchangesGAO-19-306: Published: Mar 21, 2019. Publicly Released: Mar 21, 2019.
Looking for more? Browse all our products here
Explore our Key Issues on Health Care
- Air Quality
- Elder Abuse
- Federal Efforts to Prevent Drug Misuse
- Health Care Quality and Access
- 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
- Public Health Emergency Preparedness and Response
- Reducing Government-wide Improper Payments
- Supports and Services for Transitioning Veterans
- Toxic Chemicals - High Risk Issue
- VA and DOD Health Care Management
- VA and DOD Patient Care
Explore our other Key Issues here
