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Medicare: Effective Implementation of New Legislation is Key to Reducing Fraud and Abuse

HEHS-98-59R Published: Dec 03, 1997. Publicly Released: Dec 03, 1997.
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Highlights

Pursuant to a congressional request, GAO reviewed Medicare fraud and abuse in both fee-for-service and managed care programs, focusing on: (1) the impact of inadequate payment safeguard funding on efforts to combat abusive billing; (2) ineffective oversight of fee-for-service payments and operations and Medicare managed care plans; and (3) challenges that lie ahead for the effective implementation of recent legislation that addresses fraud and abuse.

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BeneficiariesClaims processingHealth care programsHealth maintenance organizationsHome health care servicesManaged health careMedicareNoncomplianceProgram abusesQuestionable paymentsHealth care fraud