Medicaid fraud not on government radar
Rehab Regs, September 2, 2004
CMS is supporting states' Medicaid program integrity efforts through a variety of initiatives, but the agency's oversight is limited, according to the Government Accountability Office (GAO). The office's report--based on a survey completed by 47 states--found that various forms of fraud and abuse have resulted in substantial financial losses to both states and the federal government, according to PT Bulletin Online. The fraud included billing for services, drugs, equipment, and supplies not provided or needed. States reported using information technology, enrollment controls, and claims reviews to help strengthen their integrity activities. But the GAO says that CMS' current on-site review process, which aims to review the integrity efforts of eight states a year, may be disproportionately small relative to the risk of serious financial loss, according to the PT Bulletin Online.
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