Prevention of Fraud and Abuse: Medicare has realized significant savings through recoveries, judgments and settlements using audits and prosecution of fraud and abuse cases brought under the False Claims Act. The Medicare Integrity Program has reduced the claims error rate and increased recoveries from private insurers who should have paid instead of Medicare. A published study shows that increasing funds for fraud prevention/detection initiatives could lower expenditures without adversely affecting health outcomes. Further savings could be available from investing in information technology, a more rigorous review of provider qualifications and greater oversight of Medicare contracts with private health plans.
Written by Robert Berenson, Michael Hash, Thomas Ault, Beth Fuchs, Stephanie Maxwell, Lisa Potetz and Stephen Zuckerman, The Urban Institute and Health Policy Alternatives Inc.
Sarah Thomas, Project Manager, AARP Public Policy Institute
All rights are reserved and content may be reproduced, downloaded, disseminated, or transferred, for single use, or by nonprofit organizations for educational purposes, if correct attribution is made to AARP.
Public Policy Institute, AARP, 601 E Street, NW, Washington, DC 20049