Download or read book Gao 04 707 Medicaid Program Integrity written by United States Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2018-01-28 with total page 34 pages. Available in PDF, EPUB and Kindle. Book excerpt: GAO-04-707 Medicaid Program Integrity: State and Federal Efforts to Prevent and Detect Improper Payments

Download or read book Medicaid Program Integrity written by United States. General Accounting Office and published by . This book was released on 2004 with total page 36 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Medicaid Program Integrity written by U.s. Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-08-17 with total page 26 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Testimony The Centers for Medicare & Medicaid Services (CMS), the federal agency that oversees Medicaid, estimated that improper payments in the federal-state Medicaid program were $21.9 billion in fiscal year 2011. The Deficit Reduction Act of 2005 established the Medicaid Integrity Program and gave CMS an expanded role in assisting and improving the effectiveness of state activities to ensure proper payments. Making effective use of this expanded role, however, requires that federal resources are targeted appropriately and do not duplicate state activities. GAO was asked to testify on Medicaid program integrity. GAO's statement focuses on how CMS's expanded role in ensuring Medicaid program integrity (1) poses a challenge because of overlapping state and federal activities regarding provider audits and (2) presents opportunities through oversight to enhance state program integrity efforts. To do this work, GAO reviewed CMS reports and documents on Medicaid program integrity as well as its own and others' reports on this topic. In particular, GAO reviewed CMS reports that documented the results of its state oversight and monitoring activities. GAO also interviewed CMS officials in the agency's Medicaid Integrity Group (MIG), which was established to implement the Medicaid Integrity Program. This work was conducted in November and December 2011. GAO discussed the facts in this statement with CMS officials. What GAO Found The key challenge faced by the Medicaid Integrity Group (MIG) is the need to avoid duplication of federal and state program integrity efforts, particularly in the area of auditing provider claims. In 2011, the MIG reported that it was redesigning its national provider audit program. Previously, its audit contractors were using incomplete claims data to identify overpayments. According to MIG data, overpayments identified by its audit contractors since fiscal year 2009 were not commensurate with its contractors' costs. The MIG's redesign will result ..."

Download or read book Medicaid program integrity state and federal efforts to prevent and detect improper payments report to the Chairman Committee on Finance U S Senate written by and published by DIANE Publishing. This book was released on with total page 34 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Medicaid Program Integrity written by U S Government Accountability Office (G and published by BiblioGov. This book was released on 2013-07 with total page 38 pages. Available in PDF, EPUB and Kindle. Book excerpt: The U.S. Government Accountability Office (GAO) is an independent agency that works for Congress. The GAO watches over Congress, and investigates how the federal government spends taxpayers dollars. The Comptroller General of the United States is the leader of the GAO, and is appointed to a 15-year term by the U.S. President. The GAO wants to support Congress, while at the same time doing right by the citizens of the United States. They audit, investigate, perform analyses, issue legal decisions and report anything that the government is doing. This is one of their reports.

Download or read book Medicaid Program Integrity written by United States Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-09-23 with total page 36 pages. Available in PDF, EPUB and Kindle. Book excerpt: GAO has reported that Medicaid remains a high-risk program, partly due to concerns about improper payments. Screening of providers is important to help prevent improper payments. Under managed care, states contract with plans to provide services to beneficiaries. GAO was asked to examine the screening of managed care providers. GAO examined (1) states' and plans' experiences using federal databases to screen providers; and (2) how states and plans share data about ineligible providers. GAO interviewed officials from 10 states, selected generally based on enrollment and geography, and representatives from 16 plans from among these states. GAO reviewed those states' Medicaid program websites and plan contracts, and relevant federal laws, regulations, and guidance; and interviewed officials from CMS and the Department of Health and Human Services' Office of Inspector General.

Download or read book Program Integrity written by U.s. Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-08-05 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt: " In 2011, CMS estimated that Medicaid and Medicare had improper payments of $21.9 billion and almost $43 billion, respectively-among the largest for all federal programs. Both health care programs are on GAO's list of high-risk programs. Over the years, Congress has passed legislation designed to help address program integrity issues in the two programs but they remain vulnerable to fraud, waste, and abuse. The program integrity challenges are different for Medicaid and Medicare. With 51 distinct state-based programs, Medicaid has complex challenges for finding the appropriate balance between state and federal efforts. Medicare uses contractors to help administer the program and CMS must oversee their efforts. This statement examines the progress made and important steps still to be taken in these programs. GAO focused on four key strategies and recommendations that were designed to facilitate them that were identified in prior work and that could help reduce improper payments: (1) strengthening provider enrollment standards and procedures to ensure that only legitimate providers participate in the program; (2) improving prepayment controls; (3) improving postpayment claims review and recovery of improper payments; and (4) developing a robust process for addressing identified vulnerabilities. This statement is based on GAO products issued from April 2004 through May 2012 and interviews with agency officials and other stakeholders. In May 2012, GAO"

Download or read book Medicaid Program Integrity written by United States Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-10-04 with total page 34 pages. Available in PDF, EPUB and Kindle. Book excerpt: In fiscal year 2013, the Medicaid program covered about 71.7 million individuals at a cost of $431.1 billion, of which CMS estimated that $14.4 billion (5.8 percent) were improper payments. Multiple state and federal entities are involved in program integrity efforts, such as payment review, auditing, and investigating fraud. GAO was asked to examine how these entities ensure comprehensive Medicaid program integrity. This report examines state and federal roles and responsibilities to identify potential (1) gaps in efforts to ensure Medicaid program integrity coverage; and (2) fragmentation, overlap, or duplication of program integrity efforts, and efforts to coordinate activities. GAO examined relevant federal laws and regulations, CMS guidance, and state program integrity reviews. GAO also interviewed officials from CMS and HHS's Office of Inspector General, as well as PI unit and MFCU officials from seven states.

Download or read book Medicaid program integrity written by Carolyn Yocom and published by . This book was released on 2011 with total page 21 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book High risk Series written by United States. Government Accountability Office and published by . This book was released on 2005 with total page 104 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Highrisk series an update written by and published by DIANE Publishing. This book was released on with total page 95 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Medicaid Financial Management Steps Taken to Improve Federal Oversight but Other Actions Needed to Sustain Efforts written by and published by DIANE Publishing. This book was released on 2006 with total page 50 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Monthly Catalog of United States Government Publications written by and published by . This book was released on 2004-07 with total page 1102 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book A Medicaid Fraud Victim Speaks Out written by United States. Congress. House. Committee on Oversight and Government Reform. Subcommittee on Government Organization, Efficiency, and Financial Management and published by . This book was released on 2012 with total page 140 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Developments in Administrative Law and Regulatory Practice 2004 2005 written by and published by American Bar Association. This book was released on 2006 with total page 486 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Medicaid financing states use of contingencyfee consultants to maximize federal reimbursements highlights need for improved federal oversight report to the Chairman Committee on Finance U S Senate written by and published by DIANE Publishing. This book was released on with total page 98 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Medicaid Waste Fraud and Abuse written by United States. Congress. Senate. Committee on Finance and published by . This book was released on 2005 with total page 548 pages. Available in PDF, EPUB and Kindle. Book excerpt: