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GAO REPORT LIKELY TO SPUR MEDICARE AND MEDICAID PROGRAM INTEGRITY CHANGES

GAO REPORT LIKELY TO SPUR MEDICARE AND MEDICAID PROGRAM INTEGRITY CHANGES

On June 7, 2012, the Government Accountability Office (GAO) issued a report on methods to reduce improper payments to Medicare and Medicaid beneficiaries. The Centers for Medicare and Medicaid Services (CMS) reported an estimated $21.9 billion of improper payments to Medicaid and $43 billion of improper payments to Medicare in year 2011 alone.  The GAO reported four suggestions to reduce the chances for fraud, waste and abuse and to recoup overpayments including: (1) strengthening provider enrollment standards and procedures to ensure that only  legitimate providers participate in the programs; (2) improving prepayment controls; (3) improving post payment claims and review  and recovery of improper payments; and (4) developing a process for identifying vulnerabilities. GAO has suggested the use of some of its methods (presently being used to reduce improper Medicare payments) to reduce improper Medicaid payments.

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