Congressional Hearing Examines Administration's Crackdown On Health Care Fraud

Modern Healthcare: "The feds have promised to turn up the heat on providers, real and phony, who steal from and game the system. ... Lawmakers and President Barack Obama are demanding that the CMS and their partners in law enforcement do more to stem the wasted healthcare dollars gushing out of the Treasury like oil into the Gulf of Mexico. Last week the Health and Oversight subcommittees of the House Ways and Means Committee called a hearing on reducing fraud, waste and abuse in Medicare, which focused on fraud provisions of the Patient Protection and Affordable Care Act signed in March and whether they go far enough. Also last week Vice President Joe Biden and White House Budget Director Peter Orszag said the government would deploy to the CMS a computer-based fraud mapping tool credited with keeping things surprisingly clean as funds are disbursed under the American Recovery and Reinvestment Act of 2009. Orszag said the administration plans to extend the technology across the federal government." 

CMS reported progress "in overcoming the technical challenges to corralling claims data from its patchwork of payment contractors in order to track and prevent fraud and abuse, even as the government must prepare to use sophisticated data analysis to understand how the patterns of abuse adapt to new payment and delivery models encouraged by the reform law" (Blesch, 6/21).

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