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Watchdog: US Must Develop Anti-Fraud Strategy for Healthcare Programs

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The General Accounting Office (GAO) said in a report that Medicare and Medicaid are vulnerable to fraud, waste, and abuse, citing the fact the programs made $95 billion in improper payments last year.

WASHINGTON (Sputnik) — The US health agency’s Centers for Medicare and Medicaid Services (CMS) needs an anti-fraud strategy to protect more than $1 trillion in annualized expenditures at risk of fraud, the General Accounting Office said in a report.

A Medicaid office employee works on reports at Montefiore Medical Center - Sputnik International
US States Losing Billions of Dollars in Bungled Medicaid Payments
"By developing a fraud risk assessment and using that assessment to create an antifraud strategy and evaluation approach, CMS could better ensure that it is addressing the full portfolio of risks and strategically targeting the most-significant fraud risks facing Medicare and Medicaid," the report said on Tuesday.

The total cost of Medicare and Medicaid along with other healthcare insurance programs is around $1 trillion, which is all at risk, the report added.

While GAO praised CMS for some of its anti-fraud initiatives it found fault with the lack of consistent fraud-awareness training for its for employees, the report added.

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