Medicare: Application of the False Claims Act to Hospital Billing Practices

摘要

We reviewed pertinent federal laws and regulations and obtained information from211u001ethe Health Care Financing Administration (HCFA), which administers the Medicare 211u001eprogram. We also met with Health and Human Services Office of Inspecter General 211u001e(HHS-OIG) headquarters and Boston regional office staff to discuss their audits 211u001eof Medicare payments to hospitals, the data they provided to the Department of 211u001eJustice, and their work with Justice staff on the national initiatives. We met 211u001ewith Department of Justice headquarters officials and with U.S. Attorneys' 211u001eOffices in the Middle District of Pennsylvania, the Northern District of Ohio, 211u001ethe Southern District of Texas, and the Massachusetts District. We also met with 211u001efiscal intermediaries (HCFA contractors that pay claims filed by hospitals) in 211u001eMassachusetts, Ohio, and Texas.