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Health reform cuts Medicare fraud and abuse

April 25, 2012
by Sandra Hoban
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A new report by the Government Accountability Office (GAO) describes how new Medicare provider enrollment screening technology and procedures help stop fraud before it happens.

The GAO notes that the Centers for Medicare & Medicaid Services (CMS)  has strengthened its vigilance on fraud and abuse by adding new provider and supplier screening procedures, including an automated screening system that ensures that the system is up to date and accurate.

While these improvements have cut fraud and abuse, the GAO indicates that CMS still has more work to do in the areas of fraudulent billing recovery, determining which providers need to post surety bonds and establishing core elements of provider compliance programs.

GAO acknowledges the improvement in its vetting procedures, but adds in its report that CMS continues to review these processes.

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