RevCycle Intelligence December 12, 2017
CMS should offer fraud awareness training for employees and conduct a fraud risk assessment to improve its Medicaid and Medicare fraud strategy, GAO advised.
CMS demonstrates a commitment to preventing and combating Medicaid and Medicare fraud, but the federal agency’s anti-fraud efforts only partially align with the Government Accountability Office’s (GAO) Framework for Managing Fraud Risks in Federal Programs, a new report showed.
Specifically, CMS does not follow the framework because the agency lacks employee anti-fraud training, a fraud risk assessment for Medicare and Medicaid, and a risk-based anti-fraud strategy, the investigation uncovered.
“By not employing the actions identified in the Fraud Risk Framework and incorporating them in its approach to managing fraud risks, CMS is missing a significant opportunity...
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