Medicare:
Reducing Fraud and Abuse Can Save Billions
T-HEHS-95-157: Published: May 16, 1995. Publicly Released: May 16, 1995.
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GAO discussed the challenges in battling Medicare fraud and abuse, focusing on: (1) the ways providers exploit Medicare; and (2) how Medicare can be protected against fraud and abuse. GAO noted that: (1) Medicare is overwhelmed in its efforts to keep pace with fraud and abuse; (2) factors that make the Medicare claims system vulnerable to fraud and abuse include weak controls that detect questionable billing practices, few limits on those who can bill the program, and excessive reimbursement levels for certain services; (3) Medicare's budget and management problems also exacerbate these vulnerabilities; (4) the Health Care Financing Administration (HCFA) has begun several major initiatives to address long-standing problems with inappropriate Medicare payments, such as replacing the different claims processing systems with a single system, giving greater prominence to Medicare fraud and abuse activities, and initiating a new antifraud effort; and (5) despite those initiatives, HCFA has yet to develop effective ways to ensure that federal funds are spent appropriately and more demanding standards are implemented for providers seeking authority to bill Medicare.
Feb 24, 2021
Covid-19:
Key Insights from GAO's Oversight of the Federal Public Health ResponseGAO-21-396T: Published: Feb 24, 2021. Publicly Released: Feb 24, 2021.
Feb 17, 2021
Feb 11, 2021
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Operation Warp Speed:
Accelerated COVID-19 Vaccine Development Status and Efforts to Address Manufacturing ChallengesGAO-21-319: Published: Feb 11, 2021. Publicly Released: Feb 11, 2021.
Feb 5, 2021
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DOD Health Care:
DOD Should Monitor Implementation of Its Clinical Practice GuidelinesGAO-21-237: Published: Feb 5, 2021. Publicly Released: Feb 5, 2021. -
Medicaid:
CMS Needs to Implement Risk-Based Oversight of Puerto Rico's Procurement ProcessGAO-21-229: Published: Feb 5, 2021. Publicly Released: Feb 5, 2021. -
VA Health Care:
Community Living Centers Were Commonly Cited for Infection Control Deficiencies Prior to the COVID-19 PandemicGAO-21-195R: Published: Jan 6, 2021. Publicly Released: Feb 5, 2021.
Jan 28, 2021
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COVID-19:
Critical Vaccine Distribution, Supply Chain, Program Integrity, and Other Challenges Require Focused Federal AttentionGAO-21-265: Published: Jan 28, 2021. Publicly Released: Jan 28, 2021.
Jan 21, 2021
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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
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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.
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