The government recovered $2.5 billion in overpayments for the Medicare trust fund last year--up from $1.9 billion in 2008--and says that the stepped-up antifraud measures in health reform will ensure even greater future success.
As Health and Human Services Secretary Kathleen Sebelius and Attorney General Eric Holder pointed out during yesterday's news conference, the newly enacted Affordable Care Act provides an additional $300 million over the next 10 years to fight health fraud, enhances the government's oversight of companies participating in Medicare and Medicaid and lengthens prison sentences in criminal cases.
In addition, clinicians and equipment suppliers will soon face fingerprinting, site visits and criminal background checks before they can start billing Medicare, Medicaid or the Children's Health Insurance Program. A new integrated data-sharing system will allow the Department of Justice to work more closely with HHS. The effort also aims to educate consumers on how to avoid falling prey to Medicare scams. "We're going to attack fraud at every stage of the process," Sebelius said.
Investigative resources will be concentrated in areas where healthcare fraud is especially widespread, including south Florida; Los Angeles; Houston; Detroit; New York City's Brooklyn borough; Baton Rouge, La.; and Tampa, Fla., the Washington Post reports.