| Description |
1 online resource (iii, 51 p.) : ill. |
| Note |
Title from title caption (viewed on Dec. 31, 2012). |
|
"September 2012." |
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QR code for online version of document included on title page. |
| Summary |
GAO has designated Medicare and Medicaid--which are administered by the Centers for Medicare & Medicaid Services (CMS), an agency of HHS--as high-risk programs partly because their size and complexity make them vulnerable to fraud. Several federal agencies conduct health care fraud investigations and related activities, including HHS-OIG and DOJ's Civil Division, and the 93 U.S. Attorney's Offices (USAO). In fiscal year 2011, the federal government devoted at least $608 million to conduct such activities. Additionally, state MFCUs investigate health care fraud in their state's Medicaid and CHIP programs. GAO was asked to provide information on the types of providers that are the subjects of fraud cases. This report identifies provider types who were the subjects of fraud cases in (1) Medicare, Medicaid, and CHIP that were handled by federal agencies, and changes in the types of providers in 2005 and 2010; and (2) Medicaid and CHIP fraud cases that were handled by MFCUs. To identify subjects of fraud cases handled by federal agencies, GAO combined data from three agency databases--HHS-OIG, USAOs, and DOJ's Civil Division--and removed duplicate subject data. GAO also reviewed public court records, such as indictments, to identify subjects' provider types because the USAOs and DOJ Civil Division data did not consistently include provider type. To describe providers involved in fraud cases handled by the MFCUs, GAO collected aggregate data from 10 state MFCUs, which represented the majority of fraud investigations, indictments, and convictions nationwide. |
| Bibliography |
Includes bibliographical references. |
| Note |
"GAO-12-820." |
| File Type |
Text in PDF format. |
| System Details |
Mode of access: World Wide Web. |
|
System requirements: Adobe Acrobat reader. |
| Subject |
Health insurance -- Corrupt practices -- United States.
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Fraud -- Prevention -- Government policy -- United States.
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Medicare fraud -- Prevention.
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Medicaid fraud -- Prevention.
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Children's Health Insurance Program (U.S.) -- Corrupt practices.
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Governmental investigations -- United States.
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Centers for Medicare & Medicaid Services (U.S.) -- Rules and practice.
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Children's Health Insurance Program (U.S.) |
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Insurance, Health -- Child -- United States. |
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Medicare. |
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Medicaid. |
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Fraud -- legislation & jurisprudence -- United States. |
| Added Title |
Types of providers involved in Medicare, Medicaid, and the Children's Health Insurance Program cases |
| Running Title |
Fraud in Medicare, Medicaid, and CHIP |
| Gpo Item No. |
0546-D (online) |
| Sudoc No. |
GA 1.13:GAO-12-820 |
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