The current political debate in Washington centers on whether to cut government spending. However, with over $110 billion in improper or erroneous payments flowing out of the government’s coffers in 2010, the real focus should be on cutting improper government spending.
Most importantly, increased scrutiny should be directed at improper government health care spending, which accounts for a whopping 64% of the improper government payments in 2010. By focusing efforts on this sizeable $70.4 billion improper price tag, the government would see its largest return per investigative dollar.
This week, the government took steps to turn off the spigot of improper government health care dollars. Specifically, the U.S. Department of Health and Human Services rolled out its final regulations for a new Medicaid Recovery Audit Contractor (RAC) Program, mandated by the Obama Health Reform legislation of 2010. Modeled after the Medicare RAC program, this new initiative pays contractors 9 percent to 12.5 percent of any improper Medicaid payments they recover.
Undoubtedly, the Medicaid RAC program will up the number of auditors watching the stream of government spending. However, to efficiently and effectively fish out improper payments, the government still needs the inside knowledge and expertise of courageous whistleblowers. Indeed, without the help of whistleblowers to spot these seemingly innocuous claims, improper payments will easily flow by auditors.
Moreover, with a growing river of health care spending and its attendant Medicare fraud, there can be no shortage of individuals willing to suit up under the qui tam provisions of the False Claims Act. For those who successfully recover government funds via a qui tam action, their courageous actions could be worth up to 30% of the funds recovered by the government.
For more information about qui tam law and Medicare fraud, contact Nolan and Auerbach, P.A.