Medicare Fraud and Abuse

Pursuant to a legislative requirement, GAO provided information on: (1) the Department of Justice's (DOJ) implementation of its False Claims Act guidance; and (2) DOJ's U.S. Attorneys' Offices' involvement in DOJ's national health care initiatives.

GAO noted that: (1) DOJ has begun taking steps to implement its False Claims Act guidance and has designated four national antifraud projects as national initiatives; (2) however, it is too early for GAO to reach a conclusion regarding DOJ's compliance with the guidance, in part, because its working groups are in various stages of preparing documentation to guide participating U.S. Attorneys' Offices; (3) in addition, while GAO surveyed all U.S. Attorneys' Offices concerning their involvement in national initiatives, GAO still needs to visit selected offices to evaluate their compliance with the guidance; (4) GAO's survey indicated that while most offices have matters pending related to at least one of these national initiatives, such matters represent a small part of their overall civil caseload; (5) the survey also indicated that since the guidance was issued, almost seven times as many national initiative matters were closed as were opened; and (6) about one-half of these closed matters involved settlements, while the remainder did not involve any adverse actions against providers.