United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office Health, Education, and Human Services Division author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 1996-09-05 monographic deposited born digital 14 p. GA 1.13:T-HEHS-96-205 https://www.govinfo.gov/app/details/GAOREPORTS-T-HEHS-96-205 P0b002ee180386c0b f:he96205t DGPO 2010-08-12 2011-03-24 GAOREPORTS-T-HEHS-96-205 machine generated eng fdlp REPORT GAOREPORTS-T-HEHS-96-205 T-HEHS-96-205 Health care programs Fraud Federal/state relations Federal aid programs State-administered programs Health maintenance organizations Program abuses Inspectors General Health services administration Medicaid Program Medicare Program District of Columbia Illinois Maryland Missouri Virginia New York Maternal and Child Health Block Grant Social Services Block Grant Federal Employees Health Benefits Program Civilian Health and Medical Program of the Uniformed Services Illinois Medicaid Program Testimony HEHS GAO discussed whether the Department of Health and Human Services' (HHS) Office of Inspector General's (OIG) process for removing fraudulent health care providers from all federal health programs. GAO noted that: (1) weaknesses within HHS OIG allow sanctioned health care providers to remain in federal health care programs; (2) these weaknesses include lengthy delays in the OIG decision-making process, inconsistencies among OIG field offices, states not informing OIG of the providers withdrawing from state Medicaid programs, and states using information from OIG to remove excluded providers from state programs; (3) these problems compromise the financial integrity of the Medicaid program; (4) OIG field offices are unable to account for the number of referrals they receive from OIG state offices; (5) health care providers deemed unfit in one state continue to participate in Medicaid programs in other states; (6) OIG needs to consider whether it is capable of protecting beneficiaries from substandard care and ensuring the integrity of the federal health care system; and (7) OIG could become more efficient in detecting fraudulent health care providers by providing more guidance for OIG field staff, timely preparing individual case files, clarifying guidance for OIG field offices, ensuring that states act quickly in removing OIG-excluded providers from Medicaid participation, and requiring states to report providers' voluntary withdrawal from Medicaid programs to OIG field offices. https://www.govinfo.gov/content/pkg/GAOREPORTS-T-HEHS-96-205/html/GAOREPORTS-T-HEHS-96-205.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-T-HEHS-96-205/pdf/GAOREPORTS-T-HEHS-96-205.pdf GAO/T-HEHS-96-205 https://www.govinfo.gov/app/details/GAOREPORTS-T-HEHS-96-205 Testimony GAO/T-HEHS-96-205; Fraud and Abuse: Providers Excluded From Medicaid Continue to Participate in Federal Health Programs; Health care programs Fraud Federal/state relations Federal aid programs State-administered programs Health maintenance organizations Program abuses Inspectors General Health services administration Medicaid Program Medicare Program District of Columbia Illinois Maryland Missouri Virginia New York Maternal and Child Health Block Grant Social Services Block Grant Federal Employees Health Benefits Program Civilian Health and Medical Program of the Uniformed Services Illinois Medicaid Program Public Law 100-93