Hospital Links With Related Firms Can Conceal Unreasonable Costs and Increase Administrative Burden
HRD-83-18
Published: Jan 19, 1983. Publicly Released: Jan 19, 1983.
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Highlights
GAO audited five hospitals in California and Nevada to identify non-arm's-length transactions and to determine the impact of these transactions on Medicare and Medicaid. At each hospital, GAO: (1) determined who owned or controlled the hospital; (2) reviewed the hospital's organizational structure; (3) identified non-arm's-length transactions between the related organizations; (4) analyzed non-arm's-length transactions to determine the impact on Medicare and Medicaid; (5) presented preliminary findings to the appropriate paying agents; and (6) reviewed the cost report adjustments made by the intermediary and the recovery of overpayments.
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Fiscal policiesFraudHealth care costsHospital administrationMedicaidOverpaymentsProgram abusesMedicareHealth carePaying agents