Medicare Fraud

Every year, we lose billions of dollars to fraud in federal and state health care programs. Every dollar we lose to fraud and abuse is a dollar that is not available to provide home care to seniors, to treat HIV and AIDS, to immunize children, and to discover new treatments for cancer and other diseases. Some fraud schemes even pose a direct threat to the health and safety of patients. Many instances of health care fraud sug­gest that existing control systems do not work the way we imagine they should. Often the manner in which schemes are revealed suggests detection is more luck than system. Whistleblower lawsuits have exposed billing by health care providers for services not rendered, billing for products not delivered, misrepresenting services, unbundling services, billing for medically unnecessary services, duplicate billing, increasing units of service which are subject to a payment rate, falsifying cost reports resulting in increased payment to the health care provider, kickbacks, and on and on. Healthcare fraud is still going strong and this blog is intended to keep readers up to date with all healthcare fraud related news and to provide commentary when warranted. This blog also contains an array of laws and regulations concerning healthcare fraud set out in an easy to read format.

President’s Proposed 2010 Budget Aims to Increase Revenue by Reducing Fraud, Abuse

by Nolan and Auerbach on February 3, 2010

President Obama’s fiscal year 2010 proposed budget estimates that reducing health care fraud, waste and abuse could save the government about $10 billion in a decade’s time. The budget pledges nearly $1.5 billion for its Health Care Fraud and Abuse Control Program (HCFAC), including a $311 million increase in HCFAC funding. The budget takes aim at reducing Medicare and Medicaid fraud, waste and abuse by, inter alia, increasing oversight and use of national coding and technology to ensure appropriate Medicare payments for imaging and more. It also proposes to address financial conflicts of interest in physician-owned specialty hospitals. This is another firm indication that President Obama is well aware that investing in fraud detection and enforcement will return taxpayer dollars many times over.

To review the budget outline, go to http://www.whitehouse.gov/omb/budget/. Or, for more information about Medicare fraud, contact Nolan and Auerbach, PA.

Leave a Comment