United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office General Government Division author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 1996-05-01 monographic deposited born digital 100 p. GA 1.13:GGD-96-101 https://www.govinfo.gov/app/details/GAOREPORTS-GGD-96-101 P0b002ee180396076 f:gg96101 DGPO 2010-08-12 2011-03-23 GAOREPORTS-GGD-96-101 machine generated eng fdlp REPORT GAOREPORTS-GGD-96-101 GGD-96-101 Fraud Program abuses Law enforcement Health insurance cost control Data bases Proposed legislation Whistleblowers Information disclosure Computerized information systems Computer security Medicare Program Medicaid Program National Health Care Anti-Fraud Association Indexing Network System HHS National Practitioner Data Bank Federal Employees Health Benefits Program Civilian Health and Medical Program of the Uniformed Services CHAMPUS Blue Cross-Blue Shield Benefits Insurance Plan Treasury Financial Crimes Enforcement Network Chapter Report GGD

Pursuant to a congressional request, GAO discussed: (1) the extent of federal and state immunity laws protecting persons who report health care fraud; and (2) evidence for and against establishing a centralized health care fraud database.<p/>GAO found that: (1) there are no federal immunity protections for persons who report alleged health care fraud to law enforcement agencies; (2) the only federal provision that could protect such persons applies to persons reporting Medicare and Medicaid fraud; (3) private insurers and health care claims processors are also not provided any federal immunity protection if they report suspected fraud; (4) many states have enacted immunity protection, but the amount of protection varies by state; (5) Congress is considering legislation that would protect persons providing health care fraud information to the Departments of Health and Human Services or Justice; (6) most federal and state officials support the proposed immunity provisions and safeguards to protect against persons who make unsubstantiated allegations in bad faith; (7) many federal officials believe that the legislation should be expanded to provide immunity to persons sharing fraud-related information with any state or federal enforcement entity and insurers sharing information with other insurers; (8) the proposed legislation would create a central database to track criminal activity in the health care system; (9) the database would provide information on criminal convictions, civil judgements, and negative licensing actions and be accessible to federal and state agencies and health insurers; and (10) most law enforcement officials support the database's establishment and believe that enforcement benefits would accrue, but many are concerned about the potential for unauthorized disclosure of information and high development and operating costs. https://www.govinfo.gov/content/pkg/GAOREPORTS-GGD-96-101/html/GAOREPORTS-GGD-96-101.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-GGD-96-101/pdf/GAOREPORTS-GGD-96-101.pdf GAO/GGD-96-101 https://www.govinfo.gov/app/details/GAOREPORTS-GGD-96-101 Chapter Report GAO/GGD-96-101; Health Care Fraud: Information-Sharing Proposals to Improve Enforcement Efforts; Fraud Program abuses Law enforcement Health insurance cost control Data bases Proposed legislation Whistleblowers Information disclosure Computerized information systems Computer security Medicare Program Medicaid Program National Health Care Anti-Fraud Association Indexing Network System HHS National Practitioner Data Bank Federal Employees Health Benefits Program Civilian Health and Medical Program of the Uniformed Services CHAMPUS Blue Cross-Blue Shield Benefits Insurance Plan Treasury Financial Crimes Enforcement Network Title 18 Section 1341 18 U.S.C. 1341 Title 31 Section 3729 Title 31 Section 3730(h) 31 U.S.C. 3729 31 U.S.C. 3730(h) Title 42 Section 1320c-6(a) 42 U.S.C. 1320c-6(a) Volume 84 Page 1114 84 Stat. 1114 Public Law 91-508 Public Law 99-660 Public Law 102-550 Title 45 Part 60 45 CFR Part 60