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Corporate Author United States. Government Accountability Office.

Title Medicare program integrity [electronic resource] : CMS continues efforts to strengthen the screening of providers and suppliers : report to the Chairman, Committee on Finance, U.S. Senate.

Imprint [Washington, D.C.] : U.S. Govt. Accountability Office, [2012]


Location Call No. OPAC Message Status
 Axe Federal Documents Online  GA 1.13:GAO-12-351    ---  Available
Description 1 online resource (ii, 32 p.) : col. ill.
Note Title from title caption (viewed on June 6, 2012).
File Type Text in PDF format.
Note "April 2012."
Summary According to the Centers for Medicare & Medicaid Services (CMS)--the agency within the Department of Health and Human Services (HHS) that administers the Medicare program--more than 1.5 million health providers and suppliers of medical equipment were enrolled in the Medicare program in 2011, and 30,000 more enroll each month. CMS has established Medicare enrollment standards and procedures intended to ensure that only qualified providers and suppliers can enroll. While most providers and suppliers pose a limited risk to the Medicare program, our previous work found persistent weaknesses in CMS's Medicare enrollment standards and procedures that increased the risk of enrolling entities intent on defrauding the program. In 2010, the Patient Protection and Affordable Care Act (PPACA) authorized CMS to implement procedures to strengthen the Medicare enrollment process. GAO was asked to review CMS's Medicare provider enrollment procedures. In this report, GAO describes (1) how CMS and its contractors use provider and supplier enrollment information to prevent improper payments and factors that may affect the usefulness of this information, and (2) the extent to which CMS has implemented new provider and supplier enrollment screening procedures since the enactment of PPACA. To do so, GAO reviewed relevant regulations and documents, and interviewed officials from CMS and a sample of four of the agency's contractors based on the volume of claims they processed and the status of their contracts with CMS.
Bibliography Includes bibliographical references.
Note "GAO-12-351."
System Details Mode of access: World Wide Web.
System requirements: Adobe Acrobat reader.
Subject Centers for Medicare & Medicaid Services (U.S.) -- Rules and practice.
Medicare -- Management.
Medicare fraud -- United States -- Prevention.
Centers for Medicare & Medicaid Services (U.S.)
Medicare -- organization & administration.
Fraud -- prevention & control -- United States.
Added Author United States. Congress. Senate. Committee on Finance.
Added Title Medicare program integrity : Centers for Medicare and Medicaid Services continues efforts to strengthen the screening of providers and suppliers
CMS continues efforts to strengthen the screening of providers and suppliers
Running Title Provider and supplier Medicare enrollment
Gpo Item No. 0546-D (online)
Sudoc No. GA 1.13:GAO-12-351

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