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Diane Publishing Books
Medicare Integrity Program: Agency Approach for Allocating Funds Should be Revised
Leslie G. Aronovitz (au)
Since 1990, Medicare has bee considered at high risk for fraud, waste, abuse, & mismanagement. The Centers for Medicare & Medicaid Services (CMS) is tasked with safeguarding over $300 billion in program payments made on behalf of its beneficiaries. CMS conducts 5 program integrity activities; audits; med. review of claims; determinations of whether Medicare or other insur. sources have primary responsibility for payment; benefit integrity to address potential fraud cases; & provider educ. This report determined: (1) the amount of MIP funds that CMS has allocated to the 5 program integrity activities over time, (2) the approach that CMS uses to allocate MIP funds, & (3) how major changes in the Medicare program may affect MIP funding allocations. Illus.
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