Medicare Fraud and Abuse: Prevention, Detection, and Reporting

摘要

Medicare fraud and abuse is a serious problem requiring your attention. Although there is no precise measure of health care fraud and the majority of health care providers are honest and well-intentioned, a minority of providers who are intent on abusing the system can cost taxpayers billions of dollars and put beneficiaries' health and welfare at risk. The impact of these losses and risks is magnified by the growing number of people served by Medicare and the increased strain on Federal and state budgets. To combat fraud and abuse, you need to know what to watch for to protect your organization from potential abusive practices, civil liability, and perhaps criminal activity. This fact sheet gives you some of the tools you need to protect the Medicare Program, including the definitions of Medicare fraud and abuse, laws used to address fraud and abuse, overviews of partnerships among government agencies engaged in fighting fraud and abuse, and resources on how you can report suspected fraud and abuse.