ED Coding & Reimbursement Alert - 2003 Issue 39
Fraud & Abuse: HEALTH CARE PROVIDERS STILL UNDER THE GUN
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Article Overview
This article summarizes a federal fraud-and-abuse enforcement report covering health care providers, suppliers, and other participants in Medicare and Medicaid. It highlights the scale of government investigations, prosecutions, civil actions, and exclusions, and is relevant to compliance staff, billing professionals, auditors, and anyone tracking enforcement trends in government health programs.
Why This Topic Matters
Understanding current enforcement activity helps organizations assess compliance risk, monitor government priorities, and stay alert to the broader fraud-and-abuse environment affecting Medicare and Medicaid participation.
What You Will Learn
- The article’s focus on federal health care fraud enforcement activity.
- Which government agencies issued and discussed the annual report.
- The broad categories of enforcement outcomes summarized in the report.
- Why the article frames Medicare and Medicaid participation as an ongoing compliance concern.
Who Should Read This
- Medical coders
- Billing and reimbursement staff
- Compliance officers
- Healthcare auditors
- Practice managers
- Healthcare administrators
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