Momentum builds behind health care anti-fraud bill
Momentum builds behind health care anti-fraud bill
Sweeping health care anti-fraud legislation received the strong endorsement of the Department of Health and Human Services’ (HHS) Office of Inspector General, the Health Care Financing Administration (HCFA), and numerous state officials at a hearing on Medicare fraud before the House Subcommittee on Government Management, Information and Technology last week. But that bill will probably not be the last of its kind introduced this session, reports an aide to Subcommittee Chairman Stephen Horn (R-CA).
Horn’s aide says the congressman plans to incorporate some of the things learned at the July 25 hearing into legislation now being drafted. At the hearing, HCFA’s Director of Program Integrity Penny Thompson said the agency strongly supports the Medicare Fraud Prevention and Enforcement Act introduced by Rep. Judy Biggert (R-IL) in the House, and a companion bill introduced by Sen. Susan Collins (R-ME) in the Senate. That legislation would strengthen the Medicare enrollment process and expand certain standards of participation. It would also give law enforcement agencies additional tools to pursue health care fraud, including site inspections and background checks, registration of billing agencies, and expanded access to the Health Integrity and Protection Database.
The legislation would also limit the use of discharge in bankruptcy proceedings for provider liability and make Medicare carriers and fiscal intermediaries liable for claims submitted by excluded providers.
Notably, the subcommittee heard direct testimony from several convicted felons now serving time for bilking Medicare. Raymond Mederos, who was sentenced to a seven-year jail term, and Denis Spencer, who owned a laboratory in southern California, detailed the schemes they used to defraud the Medicare program before the subcommittee.
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