HCFA has new fraud-fighting plan

The Health Care Financing Administration (HCFA) in Baltimore has released a comprehensive plan for fighting fraud in the Medicare and Medicaid systems. The Comprehensive Plan for Program Integrity outlines 10 initiatives that focus on both HCFA’s internal process and the health care industry.

The five initiatives that target HCFA program integrity management are:

    • increasing the effectiveness of medical review and benefit integrity activities;
    • implementing the Medicare Integrity Program;
    • implementing payment safeguards for Balanced Budget Act provisions;
    • promoting provider integrity;
    • initiating program integrity millennium contingency planning.

The plan also lists five high-risk areas:

    • inpatient hospital care;
    • congregate care;
    • managed care;
    • community mental health center care;
    • nursing home enforcement.

For more information about the plan, visit HCFA’s Web site at http://www.hcfa.gov.