AMA launches offensive against anti-fraud plans

Responding to votes taken by delegates at its recent annual meeting, the Chicago-based American Medical Association (AMA) has taken a harder line in opposing federal anti-fraud efforts.

Skeptical of the Health Care Financing Administration's fraud and abuse statistics, the AMA plans to commission an independent audit of Medicare Part B to determine how extensive physician-related health care fraud really is.

In addition, the AMA is targeting two separate anti-fraud plans identified by delegates as particularly harmful or unfair to physicians. These include the "senior spies" program, promoted by the American Association of Retired Persons in Washington, DC, with help from HCFA and the Federal Bureau of Investigation. AMA's intention is to repeal the part of the program that provides a financial incentive to seniors who turn in their physicians.

Also raising the ire of the AMA is the Healthcare Integrity and Protection Data Bank (HIPDB), which is expected to be up and running by October. Mandated by the Health Insurance Portability and Accountability Act of 1996, HIPDB was supposed to become operational on May 19, but undisclosed technical problems have created delays, says Kay Garvey, a spokeswoman for the Health Resources and Services Administration, the agency that administers HIPDB.

Designed to identify and track physicians who have committed health care fraud, HIPDB will compile civil as well as criminal judgments. AMA claims the system serves as an "attack" on physicians and doesn’t include proper due process protections.