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Diane Publishing Books
Health Care Fraud: Types of Providers Involved in Medicare, Medicaid, and the Children劌製 Health Insurance Program Cases
Kathleen M. King (au)
GAO has designated Medicare and Medicaid -- which are administered by the Centers for Medicare & Medicaid Services (CMS), an agency of the Dept. of Health and Human Services (HHS) -- as high-risk programs partly because their size and complexity make them vulnerable to fraud. Several fed. agencies conduct health care fraud investigations and related activities, including HHS-OIG and the Dept. of Justice劌製 (DOJ) Civil Div., and the 93 U.S. Attorney劌製 Offices (USAO). In FY 2011, the fed. government devoted at least $608 million to conduct such activities. Additionally, state Medicaid Fraud Control Units (MFCUs) investigate health care fraud in their state劌製 Medicaid and Children's Health Insurance Program (CHIP) programs. This report identifies provider types who were the subjects of fraud cases in (1) Medicare, Medicaid, and CHIP that were handled by fed. agencies, and changes in the types of providers in 2005 and 2010; and (2) Medicaid and CHIP) fraud cases that were handled by MFCUs. Tables. This is a print on demand report.
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