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Medicare: Application of the False Claims Act to Hospital Billing Practices

HEHS-98-195 Published: Jul 10, 1998. Publicly Released: Aug 10, 1998.
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Highlights

Pursuant to a congressional request, GAO reviewed: (1) the False Claims Act and its application to claims involving health care programs; (2) information on the data sources, analysis, and procedures used to bring False Claims Act cases against hospitals under the 72-Hour Window Project; and (3) similar information on the Lab Unbundling Project.

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Claims processingFraudHealth insurance cost controlHospitalsMedical expense claimsMedicareOverpaymentsProgram abusesInsurance claimsMedical copayment errors