HCFA Needs to Do More to Prevent Medicare/Medicaid Fraud and Abuse

July 1, 1995

WASHINGTON--Medicare and Medicaid are hard pressed to stay ahead of profiteers bent on cheating the system administered by the Health Care Financing Administration (HCFA).

WASHINGTON--Medicare and Medicaid are hard pressed to stay aheadof profiteers bent on cheating the system administered by theHealth Care Financing Administration (HCFA).

Sarah F. Jaggar, director of health financing and policy issuesfor HCFA, testified before the House Subcommittee on Human Resourcesand Intergovernmental Relations that HCFA's fraud and abuse preventionprograms are weak.

She said that Medicare and Medicaid offer strong incentives forproviders to overprovide services, that HCFA has few controlsto detect questionable billing practices and too few limits onthe types of providers allowed to bill the federal agency, andthat there is little chance that profiteers will be prosecutedor will have to repay fraudulently obtained money.