Medicaid Fraud Control: Integrity Efforts in Selected States

Krystal O. Holtzer (Editor)

Series: Ethical Issues in the 21st Century
BISAC: MED050000



Volume 10

Issue 1

Volume 2

Volume 3

Special issue: Resilience in breaking the cycle of children’s environmental health disparities
Edited by I Leslie Rubin, Robert J Geller, Abby Mutic, Benjamin A Gitterman, Nathan Mutic, Wayne Garfinkel, Claire D Coles, Kurt Martinuzzi, and Joav Merrick


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Medicaid is a significant expenditure for the federal government and the states, with total federal outlays of $310 billion in fiscal year 2014. The Centers for Medicare & Medicaid Services (CMS) reported an estimated $17.5 billion in potentially improper payments for the Medicaid program in 2014. This book identifies and analyzes indicators of improper or potentially fraudulent payments in fiscal year 2011, and examines the extent to which federal and state oversight policies, controls, and processes are in place to prevent and detect fraud and abuse in determining eligibility.
(Imprint: Novinka)

pp. vii

Chapter 1
Medicaid: Additional Actions Needed to Help Improve Provider and Beneficiary Fraud Controls
(United States Government Accountability Office)
pp. 1-40

Chapter 2
Medicaid: Additional Reporting May Help CMS Oversee Prescription- Drug Fraud Controls
(United States Government Accountability Office)
pp. 41-84

pp. 85-89

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