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.

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President Obama

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 [...]

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President Obama Vows to Eliminate Healthcare Fraud and Reduce Waste

by Nolan and Auerbach on September 10, 2009

On Wednesday, September 9, 2009, President Barack Obama addressed Congress on the current debate over healthcare reform. In his speech, the President vowed he would eliminate “the hundreds of billions of dollars in waste and fraud.” Under his plan, an independent commission of doctors and medical experts would be appointed the task of uncovering fraud [...]

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