Medicare: Reducing Fraud and Abuse Can Save Billions (Testimony,
05/16/95, GAO/T-HEHS-95-157).

Medicare is overwhelmed in its efforts to keep pace with, much less stay
ahead of, those bent on cheating the system.  Various factors converge
to create a particularly rich environment for profiteers.  These include
the following: (1) weak fraud and abuse controls to detect questionable
billing practices, (2) few limits on those who may bill--companies using
post office box numbers have qualified to bill the program for virtually
unlimited amounts--and (3) overpayment for services.  This testimony
describes how providers exploit the system, why they are able to do so,
and what steps Medicare has taken and what remains to be done to protect
the program and the taxpayers against fraudulent reimbursement schemes
and abusive billing practices.

--------------------------- Indexing Terms -----------------------------

 REPORTNUM:  T-HEHS-95-157
     TITLE:  Medicare: Reducing Fraud and Abuse Can Save Billions
      DATE:  05/16/95
   SUBJECT:  Medicare programs
             Fraud
             Program abuses
             Overpayments
             Internal controls
             Health care cost control
             Claims processing
             Medical expense claims
             Billing procedures
             Medical information systems
IDENTIFIER:  HCFA Medicare Transaction System
             HHS Operation Restore Trust
             California
             Florida
             New York
             Illinois
             Texas
             
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