CMS rule targets Medicare fraud as GAO says more could be done

Healthcareitnews: April 24, 2012 | Bernie Monegain, Editor
WASHINGTON – Even as the Centers for Medicare & Medicaid Services (CMS) announced a final rule Tuesday aimed at preventing Medicare fraud and saving taxpayers nearly $1.6 billion over 10 years, the GAO came out with a report urging CMS to do more.


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The GAO found persistent weaknesses in Medicare’s enrollment standards and procedures that increased the risk of enrolling entities intent on defrauding the program. It called for pre- and post-payment claims review and for

mechanisms in place to resolve vulnerabilities


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“The Medicare program is difficult to measure in a reliable way,” GAO stated in its report, “but it is clear that fraud contributes to Medicare’s fiscal problems. Reducing fraud could help rein in the escalating costs of the program.”