Health Insurance:
Remedies Needed to Reduce Losses From Fraud and Abuse
T-HRD-93-8: Published: Mar 8, 1993. Publicly Released: Mar 8, 1993.
Additional Materials:
- Full Report:
Contact:
GAO discussed health care fraud and abuse and the need for better remedies and more resources to combat the problem. GAO noted that: (1) fraud and abuse encompassed a wide range of improper billing practices by physicians, medical equipment suppliers, and other suppliers that add 10 percent to U.S. health care costs; (2) whether or not health care insurers pursued a fraudulent act depended on the size of the financial loss incurred and the quality of evidence establishing intent; (3) health care fraud has expanded to organized activities affecting health care programs in both the government and private sectors; (4) obstacles that prevented insurers' efforts to detect fraud and abuse included independent health insurers, legal constraints on coordination of detection and investigation efforts, the high cost of criminal prosecution and civil pursuit of fraud, and limited resources for insurers and law enforcement agencies; (5) overcoming obstacles will require insurers, law enforcement agents, regulators, and providers to collaborate systematically on problems involving fraud and abuse; and (6) without adequate resources, investigation and pursuit of health care fraud is not possible.
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
-
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
-
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
-
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
-
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.
Looking for more? Browse all our products here