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Medicare: Recent Legislation to Minimize Fraud and Abuse Requires Effective Implementation - GAO Report
| Date: | Oct. 9, 1997 |
| Report No.: | T-HEHS-98-9 |
| Pages: | 16 |
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Subjects:
Summary: Claims processing Fraud Health care cost control Health care programs Managed health care Medicare Overpayments Program abuses Health care fraud HCFA Medicare Transaction System Medicare Choice Program With the enactment of the Health Insurance Portability and Accountability Act of 1996 and the Balanced Budget Act of 1997, Congress has provided significant opportunities to strengthen areas in the Medicare program at high risk for fraud and abuse. How Medicare will use this legislation to improve its oversight of program expenditures remains to be seen, however. The outcome depends largely on how promptly and effectively the Health Care Financing Administration (HCFA) implements the various provisions. HCFA's past efforts to implement regulations, oversee Medicare managed care plans, and acquire major computer systems have often been slow or ineffective. Now that many more demands have been placed on HCFA, GAO is concerned that the promise of the new legislation to combat health care fraud and abuse could be delayed or not realized at all. |
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