United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office Accounting and Information Management Division author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 2000-07-12 monographic deposited born digital 34 p. GA 1.13:T-AIMD/OSI-00-251 https://www.govinfo.gov/app/details/GAOREPORTS-T-AIMD-OSI-00-251 P0b002ee18039b383 f:a800251t DGPO 2010-08-12 2011-03-24 GAOREPORTS-T-AIMD-OSI-00-251 machine generated eng fdlp REPORT GAOREPORTS-T-AIMD-OSI-00-251 T-AIMD/OSI-00-251 Program evaluation Health insurance Overpayments Internal controls Program abuses Fraud Cost effectiveness analysis Health insurance cost control Performance measures Claims processing Medicare Program Medicare Fee-for-Service Program DOJ Fraud Investigation Database HCFA Comprehensive Error Rate Testing Project HCFA Payment Error Prevention Program HCFA Model Fraud Rate Project Medicare Prospective Payment System Testimony AIMD OSI

Pursuant to a congressional request, GAO discussed the Health Care Financing Administration's (HCFA) efforts to improve the measurement of improper payments in the Medicare fee-for-service program.<p/>GAO noted that: (1) because it was not intended to include procedures designed specifically to identify all types of potential fraudulent and abusive activity, the current methodology does not provide an estimate of the full extent of improper Medicare fee-for-service payments; (2) HCFA has initiated three projects designed to further its measurement efforts which offer some promise for determining the extent of improper payments attributable to potential fraud and abuse; (3) based on careful evaluation of their effectiveness, performing additional potential fraud identification techniques as part of its efforts to measure improper payments could assist HCFA in arriving at a more comprehensive measurement and, ultimately, develop cost-effective internal controls to combat improper payments; and (4) however, no set of techniques, no matter how extensive, can be expected to measure all potential fraud and abuse. https://www.govinfo.gov/content/pkg/GAOREPORTS-T-AIMD-OSI-00-251/html/GAOREPORTS-T-AIMD-OSI-00-251.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-T-AIMD-OSI-00-251/pdf/GAOREPORTS-T-AIMD-OSI-00-251.pdf GAO/T-AIMD/OSI-00-251 https://www.govinfo.gov/app/details/GAOREPORTS-T-AIMD-OSI-00-251 Testimony GAO/T-AIMD/OSI-00-251; Medicare Improper Payments: Challenges for Measuring; Program evaluation Health insurance Overpayments Internal controls Program abuses Fraud Cost effectiveness analysis Health insurance cost control Performance measures Claims processing Medicare Program Medicare Fee-for-Service Program DOJ Fraud Investigation Database HCFA Comprehensive Error Rate Testing Project HCFA Payment Error Prevention Program HCFA Model Fraud Rate Project Medicare Prospective Payment System Title 31 Section 3729 31 U.S.C. 3729