On the recordApril 14, 2011
Congress will soon debate the budget resolution for fiscal year 2012, and one of the issues under consideration is how to contain the cost of the Medicare program. While there is significant disagreement about some of the proposals already put forward, one part of the solution that members on both sides of the aisle agree on is cracking down on waste, fraud, and abuse. For several years, the Government Accountability Office has designated Medicare as a high risk program because its size and complexity make it a target for waste, fraud and abuse. Medicare pays 4.5 million claims per work day, so catching false or inflated claims is a challenge. As a result, every year an estimated $30-60 billion in Medicare spending is wasted on fraud and abuse. Under President Obama, the Executive branch has stepped up its enforcement activities. The Department of Health and Human Services and Department of Justice joined together to form Health Care Fraud Prevention and Enforcement Action Teams to combat Medicare fraud. These strike forces have netted hundreds of potential criminals in the past couple of years. Nongovernmental groups can also play a role in detecting fraud. Normally, individual Medicare providers' billing data is not available to the public as a result of a 1979 lawsuit that blocked disclosure of this information.…





