Medicare Program Integrity: Contractors Reported Generating Savings, but CMS Could Improve Its Oversight

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Our Price: $20.00

By Kathleen M. King (au)
Year: 2013
Pages: 36
Binding Paperback
ISBN 9781-4578-5216-9

Product Code: 1457852160

Description

GAO has designated Medicare as a high-risk program, in part because its size and complexity make it particularly vulnerable to fraud. To help detect and prevent potential Medicare fraud, the Centers for Medicare & Medicaid Services (CMS) -- the agency within the Department of Health and Human Services (HHS) that administers the Medicare program -- contracts with Zone Program Integrity Contractors (ZPICs). These contractors are to identify potential fraud, investigate it thoroughly and in a timely manner, and take swift action, such as working to revoke suspect providersäó» Medicare billing privileges and referring potentially fraudulent providers to law enforcement. This report examined (1) ZPIC contract costs and how ZPICs use those funds, (2) the results of ZPICsäó» work, and (3) the results of CMSäó»s evaluations of ZPICsäó» performance and aspects of CMSäó»s evaluation practices. Tables and figures. This is a print on demand report.

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