Health Care Fraud and Revenue Recovery Firms: Hearing Before the Permanent Subcommittee on Investigations of the Committee on Governmental Affairs, United States Senate, One Hundred First Congress, Second Session, June 20, 1990, Volume 4
United States. Congress. Senate. Committee on Governmental Affairs. Permanent Subcommittee on Investigations
U.S. Government Printing Office, 1990 - Fraud - 225 pages
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accounts actually American amount analysts asked Associates audit believe Boland California Carl Center charges charging policy charts Chief claims client concerned conducted contract correct costs daily documentation dollars error example Executive Exhibit fact failure findings forms goals going hospital bills hospital's identify included increase industry insurance companies issue June Kapner KWA's letter look manager MANNS Company Matthews medical record Medicare meet Michigan Miller necessary never nurse auditors O'Callaghan operations ordered overcharges paid patient payment percent performance person practice president problem procedures production questions reason received regarding reimbursement reports response result revenue recovery firms Rinzel Rodgers Roseanne Senator Roth signed specific staff statement Subcommittee submitted supplies things third-party told undercharges understanding vice Wolfberg
Page 71 - Do you swear that the testimony you are about to give before this subcommittee will be the truth, the whole truth, and nothing but the truth, so help you God ? Mr.
Page 74 - Subcommittee is in recess, subject to the call of the Chairman. [Whereupon, at...
Page 180 - These other activities include "misinterpreting" entries in the records or by simply making them up, upcoding, and unbundling. These unbilled services are submitted to third party payers for reimbursement. In addition to costing patients, insurance companies, and the Medicare program millions of dollars, our concerns with these billings take on alarming and new meaning in light of the growing sophistication being demonstrated by those submitting recovery billings to Medicare. Our investigators have...
Page 59 - ... be impaired by the existence of circumstances which reasonable people might believe likely to influence independence. To be independent, the auditor must be intellectually honest; to be recognized as independent, he must be free from any obligation to or interest in the client, its management, or its owners.
Page 177 - Mr. HORN. Thank you very much, Mr. Hast. We appreciate all of the fine work that you have done, and we now move to John E. Hartwig, the Deputy Inspector General for Investigations of the Department of Health and Human Services, with responsibility for the Health Care Financing Administration. Mr. HARTWIG. Good morning, Mr. Chairman and members of the subcommittee. It is my pleasure to appear before you today to talk about our efforts and accomplishments in the continuing fight against Medicare fraud....
Page 177 - CHAHPUS and Veterans Administration hospitals, as well as to non-Federal beneficiaries through private insurers. The result: laboratory services are a multi-billion dollar industry. The Office of Inspector General (OIG) is responsible for overseeing the more than 200 programs for our Department. We focus our efforts and resources on the Social Security and Medicare programs. These programs account for over 80 percent of the Department's budget. We pay special attention to preserving quality of service...
Page 102 - I would be happy to answer any questions you may have for me at this time.
Page 5 - Senator Cohen. OPENING STATEMENT OF SENATOR COHEN Senator COHEN. Mr. Chairman, I have a very brief statement that I would like to have entered into the record.