Healthcare Secret Shopping: An Effective Tool for Detecting Fraud and Abuse

Posted by IntegrityM | | Audit, Government Evaluation, Integrity, Medicare

The Government Accountability Office (GAO) made headlines recently when sharing news that 11 of 12 fictitious applicants obtained coverage for health insurance through the Federal marketplace. GAO targeted the Federal marketplace with secret shopping – constructing fictitious applicants who should not have received health insurance. The secret shopping applicants provided invalid Social Security information or…

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