Civil Fines and Penalties Debt: Review of Cms' (Centers for Medicare and Medicaid Services) Management and Collection Processes
This report summarizes the information presented in a briefing to Congress by the General Accounting Office (GAO) on Dec. 14, 2001, related to the Dept. of Health and Human Service's Centers for Medicare and Medicaid Services' (CMS) collection of civil fines and penalties debt, referred to as civil monetary penalties (CMP) debt. The briefing slides are included in appendix I. GAO conducted this inquiry to determine the primary reasons for the growth in reported CMP debt at CMS and whether CMS' CMP receivables have similar financial accountability and reporting issues as its non-CMP receivables.
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12 selected delinquent abuse debt According to CMS Accountability and Reporting accountability report accounts receivable Affairs k GAP allowance for uncollectible audited financial statements Centers for Medicare CMP assessments CMP debt collection CMP information CMP receivables balance Committee on Governmental DCIA debt collection policies debt to Treasury detailed subsidiary systems external financial statement FACS False Claims Act Financial Management financial statement auditors fiscal year 1997 fraud and abuse GAP Accountability Governmental Affairs health care fraud HHS OIG HIPAA Incomplete and Unreliable Issues as Non-CMP ledger lntegrity long-term care CMP LTC CMP Medicaid Services Medicare and Medicaid million non-CMP contractors Non-CMP Receivables cont'd nursing facility OMB and Treasury Overall Adequacy percent Permanent Subcommittee policies and procedures primary reason Receivables Have Similar recorded relate to CMS Reliability Background cont'd Reliability CMP Receivables Reporting Issues selected delinquent debts Senate Committee September 30 SFFAS Similar Financial Accountability Subcommittee on Investigations uncollectible accounts
Page 7 - Ranking Minority Member Permanent Subcommittee on Investigations Committee on Governmental Affairs United States Senate Dear...
Page 17 - Statement of Federal Financial Accounting Standards No. 7, Accounting for Revenue and Other Financing Sources and Concepts for Reconciling Budgetary and Financial Accounting, requires explanation of any material differences between the information required to be disclosed (including net outlays) in the financial statements and the amounts described as "actual" in the budget of the US government.
Page 23 - Oversight, and to the Chairman and Ranking Minority Member of the Senate Committee on Governmental Affairs.
Page 37 - ... within the staff and facilities available at the hospital, for such further medical examination and such treatment as may be required to stabilize the medical condition, or...
Page 13 - ... the hospital must provide for an appropriate medical screening examination within the capability of the hospital's emergency department, including ancillary services routinely available to the emergency department, to determine whether or not an emergency medical condition exists.
Page 12 - ... Enforcement of Compliance for Long-Term Care Facilities with Deficiencies SOURCE: 59 FR 56243. Nov. 10, 1994. unless otherwise noted. §488.400 Statutory basis. Sections 1819(h) and 1919(h) of the Act specify remedies that may be used by the Secretary or the State respectively when a SNF or a NF is not in substantial compliance with the requirements for participation in the Medicare and Medicaid programs. These sections also provide for ensuring prompt compliance and specify that these remedies...
Page 15 - The government's control over the practice of medicine reached new heights with the passage of the Health Insurance Portability and Accountability Act (HIPAA) in 1996.
Page 11 - To determine what role, if any, OMB and Treasury play in overseeing and monitoring the government's collection of criminal debt, we interviewed OMB and Treasury officials.
Page 41 - Ensure that contractors develop control procedures to provide independent checks of the validity, accuracy, and completeness of receivable amounts reported to HCFA. • Develop an independent internal oversight group or internal audit function to monitor the contractors...
Page 38 - not more than $10,000 for each item or service [provided],"473 as well as no more than three times "the amount claimed for each item or service in lieu of damages sustained by the United States or a State agency because of such claim." Unlike the criminal statute, this section does not impose broad CMPs for all payments made to induce any person to order a good or service from someone else, where that good or service is paid for by the Medicare program. Rather...