Health Care Reform:

How Proposals Address Fraud and Abuse

T-HEHS-94-124: Published: Mar 17, 1994. Publicly Released: Mar 17, 1994.

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GAO discussed administrative remedies that will lessen the health care system's vulnerability to fraud and abuse. GAO noted that: (1) weaknesses in current health insurance systems allow unscrupulous health care providers to cheat insurance companies and programs out of billions of dollars annually; (2) the nation's current health care information systems need to be streamlined and enhanced to reduce fraud and abuse; (3) consumers should be provided with adequate protections and empowered to make better health care choices; (4) adequate safeguards should be established against excessive cost-cutting by prepaid plans that could limit access to health care; (5) law enforcement mechanisms should be strengthened for insurers to pursue and recover money from fraudulent providers; and (6) the administration's health care reform plan and other recent reform proposals provide the basis for reducing health care fraud and abuse.

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