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Medicaid: Additional Actions Needed to Help Improve Provider and Beneficiary Fraud Controls
Medicaid: Additional Actions Needed to Help Improve Provider and Beneficiary Fraud Controls
 
Our Price: $25.00
By Seto Bagdoyan (au)
Year: 2015
Pages: 57
Binding Paperback
ISBN 978-1-4578-6890-0

Product Code: 1457868903

Description
 
Medicaid is a significant expenditure for the federal government and the states, with total federal outlays of $310 billion in FY 2014. GAO found thousands of Medicaid beneficiaries and hundreds of providers involved in potential improper or fraudulent payments during FY 2011. The Centers for Medicaid & Medicaid Services (CMS) has taken regulatory steps to make the Medicaid enrollment process more rigorous, but gaps in beneficiary-eligibility verification guidance and data sharing continue to exist. CMS reported an estimated $17.5 billion in potentially improper payments for the Medicaid program in 2014. This report (1) identifies and analyzes indicators of improper or potentially fraudulent payments in FY 2011; and (2) examines the extent to which federal and state oversight policies, controls, and processes are in place to prevent and detect fraud and abuse in determining eligibility. Tables and figures. This is a print on demand report.

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