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 1997-03-04 monographic deposited born digital 16 p. GA 1.13:T-HEHS-97-89 https://www.govinfo.gov/app/details/GAOREPORTS-T-HEHS-97-89 P0b002ee1803776ad f:he97089t DGPO 2010-08-12 2011-03-23 GAOREPORTS-T-HEHS-97-89 machine generated eng fdlp REPORT GAOREPORTS-T-HEHS-97-89 T-HEHS-97-89 Health care programs Managed health care Program abuses Health maintenance organizations Claims processing Health insurance cost control Requirements definition ADP procurement Cost effectiveness analysis Medical information systems HCFA Medicare Transaction System Medicare Program HHS Operation Restore Trust NCQA Health Plan Employer Data and Information Set Medicare Risk Contract Program Testimony HEHS GAO discussed efforts to fight fraud and abuse in the Medicare program.<p/>GAO noted that: (1) it is not surprising that because of the program's size, complexity, and rapid growth, Medicare is a charter member of GAO's high risk series; (2) in this year's report on Medicare, GAO is pleased to note that both the Congress and the Health Care Financing Administration, the Department of Health and Human Services' agency responsible for running Medicare, have made important legislative and administrative changes addressing chronic payment safeguard problems that GAO and others have identified; and (3) however, because of the significant amount of money at stake, GAO believes that the government will need to exercise constant vigilance and effective management to keep the program protected from financial exploitation. https://www.govinfo.gov/content/pkg/GAOREPORTS-T-HEHS-97-89/html/GAOREPORTS-T-HEHS-97-89.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-T-HEHS-97-89/pdf/GAOREPORTS-T-HEHS-97-89.pdf GAO/T-HEHS-97-89 https://www.govinfo.gov/app/details/GAOREPORTS-T-HEHS-97-89 Testimony GAO/T-HEHS-97-89; Medicare: Inherent Program Risks and Management Challenges Require Continued Federal Attention; Health care programs Managed health care Program abuses Health maintenance organizations Claims processing Health insurance cost control Requirements definition ADP procurement Cost effectiveness analysis Medical information systems HCFA Medicare Transaction System Medicare Program HHS Operation Restore Trust NCQA Health Plan Employer Data and Information Set Medicare Risk Contract Program