Download or read book Improper Payments Related to the Medicare Buy in Program written by and published by . This book was released on 2012 with total page 14 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare Improper Payments written by Kay Daly and published by DIANE Publishing. This book was released on 2001-04 with total page 54 pages. Available in PDF, EPUB and Kindle. Book excerpt: Reviews the Health Care Fin Admin's. (HCFA) efforts to enhance the measurement of improper payments in the Medicare fee-for-service program. Identifies structural problems that exist in the Medicare claims processing system which contribute to vulnerabilities resulting in erroneous Medicare payments. Focuses on: what HCFA proposals have been designed or initiated to measure Medicare improper payments; & the status of these proposals & initiatives & how they will enhance HCFA's ability to comprehensively measure improper Medicare payments & the frequency of kickbacks, false claims, & other inappropriate provider practices. Tables.
Download or read book Improper Payments written by Office, U.s. Government Accountability and published by . This book was released on 2017-08-16 with total page 30 pages. Available in PDF, EPUB and Kindle. Book excerpt: "GAO has designated Medicare as a high-risk program because of its size, complexity, and susceptibility to improper payments. In 2010, Medicare covered 47 million elderly and disabled beneficiaries and had estimated outlays of $516 billion. The Centers for Medicare & Medicaid Services (CMS) is the agency in the Department of Health and Human Services (HHS) responsible for administering the Medicare program and leading efforts to reduce Medicare improper payments.This testimony focuses on estimated improper payments in the Medicare program for fiscal year 2010 and the status of CMS's efforts to implement key strategies to help reduce improper payments. This testimony is primarily based on previous GAO reporting related to governmentwide improper payments, Medicare high-risk challenges and program integrity efforts, and CMS's information technology systems intended to identify improper payments. GAO supplemented that prior work with additional information on the nature and extent of Medicare improper payments reported by HHS in its fiscal year 2010 agency financial report. GAO also received updated information from CMS in February 2011 and, in select cases, as of July 2011, on its actions related to relevant laws, regulations, guidance, and open recommendations pertaining to..."
Download or read book Medicare written by U.s. Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-07-26 with total page 24 pages. Available in PDF, EPUB and Kindle. Book excerpt: " Due to its size, complexity, and susceptibility to mismanagement and improper payments, GAO has designated Medicare as a high-risk program. In 2013, Medicare financed health care services for approximately 51 million individuals at a cost of about $604 billion, and reported an estimated $50 billion in improper payments-payments that either were made in an incorrect amount or should not have been made at all. Most of these improper payments were made through the Medicare FFS program, which pays providers based on claims and uses contractors to pay the claims and ensure program integrity. This statement focuses on the progress made and steps still to be taken by CMS to improve improper payment prevention and recoupment efforts in the Medicare FFS program. This statement is based on relevant GAO products and recommendations issued from 2007 through 2014 using a variety of methodologies. GAO also updated information by examining public documents and, in April 2014, GAO received updated information from CMS on its actions related to laws and regulations discussed in this statement. What GAO Found The Centers for Medicare & Medicaid Services (CMS), the agency within the Department of Health and Human Services (HHS) that oversees Medicare, has made progress improving improper payment prevention and recoupment efforts in the Medicare fee-for-service (FFS) program, but further actions are needed. Provider enrollment. CMS has implemented certain provider enrollment screening procedures authorized by the Patient Protection and Affordable Care Act (PPACA) that address past weaknesses identified by GAO and others. The agency has also put in place other measures intended to strengthen existing procedures, but could do more to improve provider enrollment screening and ultimately reduce improper payments. For example, CMS has hired contractors to determine whether providers and suppliers have valid licenses, meet certain Medicare standards, and are at legitimate locations. CMS also recently contracted for fingerprint-based criminal history checks of providers and suppliers it has identified as high-risk. However, CMS has not implemented other screening actions authorized by PPACA that could further strengthen provider enrollment. Prepayment controls. In response to GAO's prior recommendations, CMS has taken steps to improve the development of certain prepayment edits-prepayment controls used to deny Medicare claims that should not be paid; however, important actions that could further prevent improper payments have not yet been implemented. For example, CMS has implemented an automated edit to identify services billed in medically unlikely amounts, but has not implemented a GAO recommendation to examine certain edits to determine whether they should be revised to reflect more restrictive payment limits. GAO has found that wider use of prepayment edits could help prevent improper payments and generate savings for Medicare. Postpayment claims reviews. Postpayment claims reviews help CMS identify and recoup improper payments. Medicare uses a variety of contractors to conduct such reviews, which generally involve reviewing a provider's documentation to ensure that the service was billed properly and was covered, reasonable, and necessary. GAO has found that differing requirements for the various contractors may reduce the efficiency and effectiveness of such reviews. To improve these reviews, GAO has previously recommended CMS examine ways to make the contractor requirements more consistent.
Download or read book The Medicare Handbook written by and published by . This book was released on 1989 with total page 48 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Health Care Fraud and Abuse written by Aspen Health Law Center and published by . This book was released on 1998 with total page 156 pages. Available in PDF, EPUB and Kindle. Book excerpt: Stepped-up efforts to ferret out health care fraud have put every provider on the alert. The HHS, DOJ, state Medicaid Fraud Control Units, even the FBI is on the case -- and providers are in the hot seat! in this timely volume, you'll learn about the types of provider activities that fall under federal fraud and abuse prohibitions as defined in the Medicaid statute and Stark legislation. And you'll discover what goes into an effective corporate compliance program. With a growing number of restrictions, it's critical to know how you can and cannot conduct business and structure your relationships -- and what the consequences will be if you don't comply.
Download or read book Title XX Social Services written by and published by . This book was released on 1980 with total page 40 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare coverage of diabetes supplies services written by and published by . This book was released on 2002 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Departments of Labor Health and Human Services Education and Related Agencies Appropriations for 2008 written by United States. Congress. House. Committee on Appropriations. Subcommittee on the Departments of Labor, Health and Human Services, Education, and Related Agencies and published by . This book was released on 2007 with total page 1984 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Departments of Labor and Health and Human Services Education and Related Agencies Appropriations written by United States. Congress. Senate. Committee on Appropriations and published by . This book was released on 2007 with total page 612 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Departments of Labor Health and Human Services Education and Related Agencies Appropriations for 2008 Part 2B 110 1 Hearings written by and published by . This book was released on 2007 with total page 1980 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Management Matters written by United States. Congress. Senate. Committee on Homeland Security and Governmental Affairs and published by . This book was released on 2014 with total page 230 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Departments of Labor Health and Human Services Education and Related Agencies Appropriations for Fiscal Year 2007 written by United States. Congress. Senate. Committee on Appropriations. Subcommittee on Departments of Labor, Health and Human Services, Education, and Related Agencies and published by . This book was released on 2006 with total page 2020 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Opportunities to Reduce Potential Duplication in Government Programs Save Tax Dollars and Enhance Revenue written by and published by DIANE Publishing. This book was released on with total page 345 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Eliminating Agency Payment Errors written by United States. Congress. Senate. Committee on Homeland Security and Governmental Affairs. Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security and published by . This book was released on 2008 with total page 164 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Reporting Improper Payments written by United States. Congress. Senate. Committee on Homeland Security and Governmental Affairs. Subcommittee on Federal Financial Management, Government Information, and International Security and published by . This book was released on 2007 with total page 164 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book A Ticking Time Bomb written by United States. Congress. Senate. Committee on Homeland Security and Governmental Affairs and published by . This book was released on 2011 with total page 304 pages. Available in PDF, EPUB and Kindle. Book excerpt:
