Obama administration: Hot on healthcare fraud

Sunday, May 24, 2009

WASHINGTON - Two members of Obama's administration announced last week the creation of a new interagency fraud effort, the Health Care Fraud Prevention and Enforcement Action Team (HEAT).

Attorney General Eric Holder and Department of Health and Human Services (HHS) Secretary Kathleen Sebelius said that HEAT will focus on preventing fraud in the first place. Building on demo projects by HHS and CMS that focus on DME providers, initiatives will include increasing site visits to potential providers to prevent imposters from posing as legitimate providers; increasing training for providers on Medicare compliance; and improving data sharing between CMS and law enforcement.

"We are turning up the heat on perpetrators who steal from the taxpayers and threaten the future of Medicare and Medicaid," Sebelius stated in a release. "Most providers are doing the right thing and providing care with integrity. But we cannot and will not allow billions of dollars to be stolen from Medicare and Medicaid through fraud, waste and service abuse of the system. It's time to bring the fight against fraud into the 21st century and put the resources on the streets and out into the community to protect the American taxpayers and lower the cost of health care."

Holder and Sebelius also announced the expansion of Strike Force operations to Detroit and Houston. Strike Force teams are already in place in Miami (146 convicted and $186 million in criminal fines and civil recoveries secured since 2007) and Los Angeles (37 convicted and $55 million ordered in restitution).

AAHomecare supports the government's expanded anti-fraud efforts. The association, in a release following Holder and Sebelius' announcement, again encouraged members of Congress and CMS to take it even a step further by adopting its 13-point plan. The plan includes measures like requiring site inspections for all provider renewals and requiring a six-month trial period for new providers.

"For a long time, the activities of criminals have tarnished the good name of honest providers of home medical equipment and services," stated Tyler Wilson, AAHomecare's president. "We support expanded and more effective government efforts to stamp out fraud."