title: The reasonable and necessary criterion and Medicare contractor review of claims: efforts to combat fraud, waste and abuse in the Medicare program.
authors.affiliation: Provider Purchasing and Administration Group, Center for Health Plans and Providers, Health Care Financing Administration, USA.
authors.forename: G
authors.initials: G
authors.lastname: Nicholson
authors.forename: L
authors.initials: L
authors.lastname: Robins
mesh_terms: D000368:Aged; D002017:Budgets; D003284:Contract Services; D018588:Fee-for-Service Plans / Q000191:economics; D005375:Financial Audit; D005607:Fraud / Q000331:legislation & jurisprudence / Q000517:prevention & control*; D006300:Health Services Misuse / Q000331:legislation & jurisprudence*; D006801:Humans; D007343:Insurance Carriers; D007345:Insurance Claim Review / Q000592:standards*; D007349:Insurance, Health, Reimbursement / Q000592:standards*; D008485:Medical Audit; D006278:Medicare / Q000331:legislation & jurisprudence / Q000458:organization & administration* / Q000592:standards; D014481:United States; D014483:United States Dept. of Health and Human Services