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<classification authority="sudocs">GA 1.13:GAO-01-114R</classification>
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 <subject>Fraud</subject>
 <subject>Program abuses</subject>
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 <subject>Health insurance</subject>
 <subject>Internal controls</subject>
 <subject>Contract oversight</subject>
 <identifier>Medicare Program</identifier>
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<titleInfo>
 <title>Medicare: HCFA to Strengthen Medicare Provider Enrollment</title>
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<abstract>One of the first defenses against improper Medicare billings is the
screening of applications from providers seeking to participate in the
program. The Health Care Financing Administration (HCFA) operates and
manages the Medicare program and, with help from insurance companies,
reviews provider applications to determine whether providers meet
Medicare requirements and if there is a reason to suspect that
providers&apos; future Medicare billings would be improper. GAO found that
HCFA&apos;s current provider enrollment process does not completely ensure
that dishonest and unqualified providers are prevented from obtaining
Medicare billing privileges. GAO suggests consolidating provider
enrollment tasks with fewer contractors to strengthen HCFA&apos;s ability to
oversee these contractors and enhance the efficiency of the enrollment
process. HCFA is implementing several changes to its provider enrollment
processes that may make it more difficult for dishonest providers to
enroll in Medicare; however, delays in implementing these initiatives
will also postpone their benefits.</abstract>
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<note>Correspondence</note>
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<subject>
 <topic>Fraud</topic>
 <topic>Program abuses</topic>
 <topic>Health care programs</topic>
 <topic>Health insurance</topic>
 <topic>Internal controls</topic>
 <topic>Contract oversight</topic>
 <topic>Medicare Program</topic>
 <topic>HCFA Provider Enrollment Chain and Ownership System</topic>
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  <title>United States Public Law 33 (105th Congress)</title>
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