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Health Care: Fraud Schemes Committed by Career Criminals and Organized Criminal Groups and Impact on Consumers and Legitimate Health Care Providers

OSI-00-1R Published: Oct 05, 1999. Publicly Released: Nov 04, 1999.
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Highlights

Pursuant to a congressional request, GAO provided information on the proliferation of Medicare, Medicaid, and private health insurance fraud on the part of criminals and organized criminal groups, focusing on: (1) the makeup and prior activities of such groups; (2) how organized criminal groups created medical entities or used legitimate medical entities or individuals to defraud Medicare, Medicaid, and private insurers; (3) schemes used by such groups to commit health care fraud; and (4) the impact that illegal activity by such groups has on consumers and legitimate health care providers.

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FraudHealth care cost controlHealth care programsHealth insuranceMedicaidMedical expense claimsOrganized crimeProgram abusesHealth care fraudMedicare