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Government Reports on Fraud

OIG May 2010 – Memorandum Report:  Excluded Medicaid Providers:  Analysis of Enrollment
 
DHHS and DOJ May 2010 – Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2009
 
GAO April 2010 – CMS: Pervasive Internal Control Weaknesses Hindered Effective Contract Management

GAO April 2010 – Medicare Contracting Reform: Agency Has Made Progress with Implementation, But Contractors Have Not Met All Performance Standards

GAO March 2010 – Medicare Recovery Audit Contracting – Weaknesses Remain in Addressing Vulnerabilities to Improper Payments, Although Improvements Made to Contractor Oversight.
 
GAO March 2010 – Medicare Part D – CMS Oversight of Part D Sponsors’ Fraud and Abuse Programs Has Been Limited, but CMS Plans Oversight Expansion
 
GAO November 2009 – Medicare – CMS Working to Address Problems from Round 1 of the Durable Medical Equipment Competitive Bidding Program

GAO November 2009 – Medicaid – Ongoing Federal Oversight of Payments to Offset Uncompensated Hospital Care Costs Is Warranted

GAO September 2009 – Medicaid – Fraud and Abuse Related to Controlled Substances Identified in Selected States

OIG August 2009 – MSIS Date Usefulness for Detecting Fraud, Waste and Abuse
 
OIG August 2009 – Inappropriate Medicare Payments for Pressure Reducing Support Surfaces
 

GAO March 2009 – Medicare – Improvements Needed to Address Improper Payments in Home Health

GAO January 2009 – Report to Congress – “High-Risk Series:  An Update”

GAO July 2008 – Medicare Part D – “Some Plan Sponsors Have Not Completely Implemented Fraud and Abuse Programs, and CMS Oversight Has Been Limited”

GAO July 2008 – Medicare – “Covert Testing Exposes Weaknesses in the Durable Medical Equipment Supplier Screening Process”

GAOMay 2008 – Medicaid – “CMS Needs More Information on the Billions of Dollars Spent on Supplemental Payments”

GAO April 2008 – Medicaid Financing – “Long-standing Concerns about Inappropriate State Arrangements Support Need for Improved Federal Oversight”

GAOJanuary 2008 – Medicaid Demonstration Waivers – “Recent HHS Approvals Continue to Raise Cost and Oversight Concerns”

GAOJuly 2007 – Medicare – “Improvements Needed to Address Improper Payments for Medical Equipment and Supplies”

GAO March 2007 – Medicaid Financing – “Federal Oversight Initiative is Consistent with Medicaid Payment Principles but Needs Greater Transparency”

GAO June 2006 – Medicaid Financial Management – “Steps Taken to Improve Federal Oversight but Other Actions Needed to Sustain Efforts”

GAO March 2006 – Medicaid Integrity – “Implementation of New Program Provides Opportunities for Federal Leadership to Combat Fraud, Waste, and Abuse”

GAO September 2005 – Medicare – “More Effective Screening and Stronger Enrollment Standards Needed for Medical Equipment Suppliers”

GAO June 2005 – Medicaid Fraud and Abuse – “CMS’s Commitment to Helping States Safeguard Program Dollars is Limited”

GAO June 2005 – Medicaid Financing – “States’ Use of Contingency-Fee Consultants to Maximize Federal Reimbursements Highlights Need for Improved Federal Oversight”

GAO June 2005 – Medicaid Drug Rebate Program – “Inadequate Oversight Raises Concerns about Rebates Paid to States”

GAO June 2005 – Medicaid – “States’ Efforts to Maximize Federal Reimbursements Highlight Need for Improved Federal Oversight”

GAO July 2004 – Medicaid Program Integrity – “State and Federal Efforts to Prevent and Detect Improper Payments”

GAO March 2004 – Medicaid – “Intergovernmental Transfers Have Facilitated State Financing Schemes”

GAO February 2004 – Medicaid – “Improved Federal Oversight of State Financing Schemes Is Needed”

GAO June 2002 – Medicaid Financial Management – “Better Oversight of State Claims for Federal Reimbursement Needed”

GAO October 2001 – Medicaid – “HCFA Reversed Its Position and Approved Additional State Financing Schemes”

GAO October 2001 – Strategies to Manage Improper Payments – “Learning from Public and Private Sector Organizations”

GAO June 2001 – Medicaid – “State Efforts to Control Improper Payments Vary”

GAO September 2000 – Medicaid – “State Financing Schemes Again Drive Up Federal Payments”

GAO July 2000 – Health Care Fraud – “Schemes to Defraud Medicare, Medicaid, and Private Health Care Insurers”

GAO July 2000 – Medicaid – “HCFA and State Could Work Together to Better Ensure the Integrity of Providers”

GAO April 2000 – Medicaid in Schools – “Improper Payments Demand Improvements in HCFA Oversight”

GAO November 1999 – Medicaid – “Federal and State Leadership Needed to Control Fraud and Abuse”

GAO March 1997 – Medicaid Fraud and Abuse – “Stronger Action Needed to Remove Excluded Providers From Federal Health Programs”

GAO March 1996 – Fraud and Abuse – “Providers Excluded From Medicaid Continue to Participate in Federal Health Programs”

GAO March 1995 – Medicare and Medicaid – “Opportunities to Save Program Dollars by Reducing Fraud and Abuse”

GAO August 1993 – Medicaid Drug Fraud – “Federal Leadership Needed to Reduce Program Vulnerabilities”
OIG December 2009 – Medicare Power Wheelchair Claims Frequently Did Not Meet Documentation Requirements
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Stop Paying the Crooks

Stop Paying the Crooks: 
Solutions to End the Fraud
that Threatens Your Healthcare

Foreword: Newt Gingrich
Editor: James Frogue

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