During today’s Senate Finance Committee hearing, Chairman Max Baucus (D-Mont.) examined a landmark Medicare fraud bust and called it a sign that new fraud prevention measures stemming from healthcare reform are working.
“Health care fraud adds to the deficit, wastes taxpayer dollars and forces seniors to spend more out of their tight budgets on Medicare premiums. We’re making major progress in the fight against fraud thanks to new tools from health reform, and we need to keep it up,” Baucus said. “Health reform gives law enforcement the authority to stop payments and investigate suspicious claims before taxpayer money goes out the door. And health reform also improves screening to ensure criminals can’t get in to Medicare or Medicaid. A single dollar lost to fraud is too much, so this effort to root out criminals and scammers must continue.”
The National Association for Home Care & Hospice (NAHC) praised Baucus, along with Sen. Orrin Hatch (R-Utah), for their efforts to increase the coordination of federal and state enforcement agencies to fight health care fraud and abuse.
Using certain program integrity measures can help reduce the number of fraud cases, including implementing a moratorium on new providers, and NAHC says it wants the Centers for Medicare & Medicaid Services (CMS) to “move forward” with the authority it’s been given through the Affordable Care Act to do so.
The health reform law includes numerous provisions to help prevent high risk parties from entering Medicare in the first places, says NAHC, as well as measures to catch them as quickly as possible in the event they abuse the system. These include stricter provider participation screenings and a limit on outlier payment billings that eliminated a billion dollar systemic abuse by certain home health businesses (including the companies highlighted during Tuesday’s hearing).
“We believe that Medicare has no resources to waste and that fraud is the most preventable form of such waste,” NAHC says.
Written by Alyssa Gerace