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• Figure 1: Provider Enrollment, Prepayment Review, and Post-payment Review of Medicaid Claims Data

  • Uploaded by: U.S. Government Accountability Office
  • License: United States Government Work
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  • 1 favorite
  • 2,178 views
  • Date uploaded: 2015-03-10
  • Tags: gao, governmentaccountabilityoffice, usgovernmentaccountabilityoffice, usgao, unitedstatesgovernmentaccountabilityoffice, government, congress, watchdog, oversight, governmentwatchdog, gao15207, medicaidinformationtechnology, cms, centersformedicaremedicaidservices, hhs, departmentofhealthandhumanservices, it, informationtechnology, mmis, medicaidmanagementinformationsystem, ncci, nationalcorrectcodinginitiative, pecos, providerenrollmentchainandownershipsystem, ppaca, patientprotectionandaffordablecareact, surs, surveillanceandutilizationreviewsubsystem
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• Figure 4: Federal-State Medicaid Partnership Framework

  • Uploaded by: U.S. Government Accountability Office
  • License: United States Government Work
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  • 1,875 views
  • Date uploaded: 2015-09-01
  • Tags: gao, governmentaccountabilityoffice, usgovernmentaccountabilityoffice, usgao, unitedstatesgovernmentaccountabilityoffice, government, congress, watchdog, oversight, governmentwatchdog, gao15677, medicaid, epop, employmenttopopulationratio, cbo, congressionalbudgetoffice, chip, statechildrenshealthinsuranceprogram, cms, centersformedicaremedicaidservices, dsh, disproportionatesharehospital, epsdt, earlyandperiodicscreeningdiagnosticandtreatment, fmap, federalmedicalassistancepercentage, fpl, federalpovertylevel, hcera, healthcareandeducationreconciliationactof2010, hhs, departmentofhealthandhumanservices, it, informationtechnology, ltss, longtermservicesandsupports, macpac, medicaidandchippaymentandaccesscommission, mco, managedcareorganization, mmis, medicaidmanagementinformationsystem, msis, medicaidstatisticalinformationsystem, tmsis, transformedmedicaidstatisticalinformationsystem, oig, officeofinspectorgeneral, pecos, providerenrollmentchainandownershipsystem, ppaca, patientprotectionandaffordablecareact, upl, upperpaymentlimit
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• Figure 3: GAO Sample Estimates of Provider and Supplier Practice Location Addresses in PECOS Using the USPS Address- Management Tool

  • Uploaded by: U.S. Government Accountability Office
  • License: United States Government Work
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  • 1,811 views
  • Date uploaded: 2015-08-25
  • Tags: gao, governmentaccountabilityoffice, usgovernmentaccountabilityoffice, usgao, unitedstatesgovernmentaccountabilityoffice, government, congress, watchdog, oversight, governmentwatchdog, gao15448, medicareprogram, cmra, commercialmailreceivingagency, cms, centersformedicaremedicaidservices, dmepos, durablemedicalequipmentprostheticsorthoticsandsupplies, fsmb, federationofstatemedicalboards, hhs, departmentofhealthandhumanservices, lcm, licensecontinuousmonitoring, leie, listofexcludedindividualsandentities, mac, medicareadministrativecontractor, nsc, nationalsupplierclearinghouse, oig, officeofinspectorgeneral, pecos, providerenrollmentchainandownershipsystem, ppaca, patientprotectionandaffordablecareact, ssa, socialsecurityadministration, ups, unitedparcelservice, usps, unitedstatespostalservice
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• Figure 4: Mailbox Rental Store with a Suite Number Address Used as a Provider Practice Location

  • Uploaded by: U.S. Government Accountability Office
  • License: United States Government Work
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  • 1,706 views
  • Date uploaded: 2015-08-25
  • Tags: gao, governmentaccountabilityoffice, usgovernmentaccountabilityoffice, usgao, unitedstatesgovernmentaccountabilityoffice, government, congress, watchdog, oversight, governmentwatchdog, gao15448, medicareprogram, cmra, commercialmailreceivingagency, cms, centersformedicaremedicaidservices, dmepos, durablemedicalequipmentprostheticsorthoticsandsupplies, fsmb, federationofstatemedicalboards, hhs, departmentofhealthandhumanservices, lcm, licensecontinuousmonitoring, leie, listofexcludedindividualsandentities, mac, medicareadministrativecontractor, nsc, nationalsupplierclearinghouse, oig, officeofinspectorgeneral, pecos, providerenrollmentchainandownershipsystem, ppaca, patientprotectionandaffordablecareact, ssa, socialsecurityadministration, ups, unitedparcelservice, usps, unitedstatespostalservice
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• Figure 7: No Real Working Offices Operating in Provider's Practice Location Address

  • Uploaded by: U.S. Government Accountability Office
  • License: United States Government Work
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  • 1,698 views
  • Date uploaded: 2015-08-25
  • Tags: gao, governmentaccountabilityoffice, usgovernmentaccountabilityoffice, usgao, unitedstatesgovernmentaccountabilityoffice, government, congress, watchdog, oversight, governmentwatchdog, gao15448, medicareprogram, cmra, commercialmailreceivingagency, cms, centersformedicaremedicaidservices, dmepos, durablemedicalequipmentprostheticsorthoticsandsupplies, fsmb, federationofstatemedicalboards, hhs, departmentofhealthandhumanservices, lcm, licensecontinuousmonitoring, leie, listofexcludedindividualsandentities, mac, medicareadministrativecontractor, nsc, nationalsupplierclearinghouse, oig, officeofinspectorgeneral, pecos, providerenrollmentchainandownershipsystem, ppaca, patientprotectionandaffordablecareact, ssa, socialsecurityadministration, ups, unitedparcelservice, usps, unitedstatespostalservice
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• Figure 8: Reported Practice Location Verified by Using the Phone Verification Method

  • Uploaded by: U.S. Government Accountability Office
  • License: United States Government Work
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  • 1,609 views
  • Date uploaded: 2015-08-25
  • Tags: gao, governmentaccountabilityoffice, usgovernmentaccountabilityoffice, usgao, unitedstatesgovernmentaccountabilityoffice, government, congress, watchdog, oversight, governmentwatchdog, gao15448, medicareprogram, cmra, commercialmailreceivingagency, cms, centersformedicaremedicaidservices, dmepos, durablemedicalequipmentprostheticsorthoticsandsupplies, fsmb, federationofstatemedicalboards, hhs, departmentofhealthandhumanservices, lcm, licensecontinuousmonitoring, leie, listofexcludedindividualsandentities, mac, medicareadministrativecontractor, nsc, nationalsupplierclearinghouse, oig, officeofinspectorgeneral, pecos, providerenrollmentchainandownershipsystem, ppaca, patientprotectionandaffordablecareact, ssa, socialsecurityadministration, ups, unitedparcelservice, usps, unitedstatespostalservice
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• Figure 5: Demolished Site Listed as Provider’s Practice Location

  • Uploaded by: U.S. Government Accountability Office
  • License: United States Government Work
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  • 1,583 views
  • Date uploaded: 2015-08-25
  • Tags: gao, governmentaccountabilityoffice, usgovernmentaccountabilityoffice, usgao, unitedstatesgovernmentaccountabilityoffice, government, congress, watchdog, oversight, governmentwatchdog, gao15448, medicareprogram, cmra, commercialmailreceivingagency, cms, centersformedicaremedicaidservices, dmepos, durablemedicalequipmentprostheticsorthoticsandsupplies, fsmb, federationofstatemedicalboards, hhs, departmentofhealthandhumanservices, lcm, licensecontinuousmonitoring, leie, listofexcludedindividualsandentities, mac, medicareadministrativecontractor, nsc, nationalsupplierclearinghouse, oig, officeofinspectorgeneral, pecos, providerenrollmentchainandownershipsystem, ppaca, patientprotectionandaffordablecareact, ssa, socialsecurityadministration, ups, unitedparcelservice, usps, unitedstatespostalservice
  • Visibility: public