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Health Insurance: Remedies Needed to Reduce Losses From Fraud and Abuse

  Premium   Download PDF Now (12 pages)
Report Type Reports and Testimonies
Report Date March 8, 1993
Report No. T-HRD-93-8
Subject
Summary:

Health insurance experts estimate that fraud and abuse contribute to about 10 percent of the nation's $800-plus billion health care bill. Yet only a fraction of this fraud and abuse is ever identified and prosecuted. Without adequate resources, investigation and pursuit of much of the health care fraud is impossible. A shortage of staff and money dedicated to pursuing fraud and abuse has allowed dishonest providers to stay in business. More resources alone, however, will not overcome fraud and abuse in the health insurance industry. GAO believes that the efforts of independent private payers, public payers, and state insurance and licensing agencies as well as state and federal law enforcement agencies need to be better coordinated. This would help overcome the systemic obstacles that hamper efforts to address health care fraud.

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