Fraud Detection Systems: Centers for Medicare and Medicaid Services Needs to Ensure More Widespread Use

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Description

A letter report issued by the Government Accountability Office with an abstract that begins "GAO has designated Medicare and Medicaid as high-risk programs, in part due to their susceptibility to improper payments--estimated to be about $70 billion in fiscal year 2010. Improper payments have many causes, such as submissions of duplicate claims or fraud, waste, and abuse. As the administrator of these programs, the Centers for Medicare and Medicaid Services (CMS) is responsible for safeguarding them from loss. To integrate claims information and improve its ability to detect fraud, waste, and abuse in these programs, CMS initiated two information technology ... continued below

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United States. Government Accountability Office. June 30, 2011.

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Description

A letter report issued by the Government Accountability Office with an abstract that begins "GAO has designated Medicare and Medicaid as high-risk programs, in part due to their susceptibility to improper payments--estimated to be about $70 billion in fiscal year 2010. Improper payments have many causes, such as submissions of duplicate claims or fraud, waste, and abuse. As the administrator of these programs, the Centers for Medicare and Medicaid Services (CMS) is responsible for safeguarding them from loss. To integrate claims information and improve its ability to detect fraud, waste, and abuse in these programs, CMS initiated two information technology system programs: the Integrated Data Repository (IDR) and One Program Integrity (One PI). GAO was asked to (1) assess the extent to which IDR and One PI have been developed and implemented and (2) determine CMS's progress toward achieving its goals and objectives for using these systems to help detect fraud, waste, and abuse. To do so, GAO reviewed system and program management plans and other documents and compared them to key practices. GAO also interviewed program officials, analyzed system data, and reviewed reported costs and benefits."

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Government Accountability Office Reports

The U.S. Government Accountability Office (GAO) is an independent, nonpartisan agency that works for the U.S. Congress investigating how the federal government spends taxpayers' money. Its goal is to increase accountability and improve the performance of the federal government. The Government Accountability Office Reports Collection consists of over 13,000 documents on a variety of topics ranging from fiscal issues to international affairs.

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  • June 30, 2011

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  • June 12, 2014, 7:50 p.m.

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United States. Government Accountability Office. Fraud Detection Systems: Centers for Medicare and Medicaid Services Needs to Ensure More Widespread Use, report, June 30, 2011; Washington D.C.. (digital.library.unt.edu/ark:/67531/metadc300609/: accessed October 18, 2017), University of North Texas Libraries, Digital Library, digital.library.unt.edu; crediting UNT Libraries Government Documents Department.