Politics

$2,510,000,000

By Karina

Today, Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius issued a new report showing anti-fraud enforcement and prevention efforts by the Obama Administration resulted in more than $2.5 billion returned to the Medicare Trust Fund and over $441 million in federal Medicaid money was returned to the US Treasury (a nearly 30% increase over the previous year under President Bush).

Reducing waste, fraud, and abuse saves taxpayer dollars and protects the health care investments made by individuals, businesses, and government. The Affordable Care Act enhances these efforts and strengthens Medicare and Medicaid’s existing compliance and enforcement tools, saving billions of taxpayer dollars. Some key anti-fraud provisions in the new health reform law are:

Tough New Rules and Sentences for Criminals
The Affordable Care Act directs the Sentencing Commission to increase the Federal sentencing guidelines for health care fraud offenses by 20-50% for crimes that involve more than $1,000,000 in losses. The law makes obstructing a fraud investigation a crime, and makes it easier for the government to recapture any funds acquired through fraudulent practices.

Enhanced Screening of Providers
The Affordable Care Act provides critical tools for fraud prevention, including new authorities for stepped-up oversight of providers and suppliers participating in Medicare, Medicaid, or CHIP, such as mandatory licensure checks. Based on the level of risk of fraud, waste and abuse, providers could be subject to fingerprinting, site visits and criminal background checks before they begin billing Medicare, Medicaid, or CHIP.

Significant New Resources
The Affordable Care Act provides an additional $350 million over the next ten years to help fight fraud.
Requiring Providers to Help Prevent Fraud: The Affordable Care Act requires providers and suppliers to establish plans detailing how they will follow the rules and prevent fraud as a condition of enrollment in Medicare, Medicaid, or CHIP.

Greater Oversight of Private Insurance Abuses
The new law also provides enhanced tools and authorities to address abuses of multiple employer welfare arrangements and protect employers and employees from insurance scams. It also gives new powers to the Secretary and Inspector General to investigate and audit the Health Insurance Exchanges.

Learn more about preventing waste, fraud & abuse in the Affordable Care Act»

To learn more about how to fight fraud in our health system visit http://www.stopmedicarefraud.gov/.

Full post as published by The Gavel on May 13, 2010 (boomark / email).