Posted by Dorkina Myrick, M.D., Ph.D.
The Senate Finance Committee addresses Medicare and Medicaid Waste, Fraud, and Abuse in a new report released on January 31. The Medicare and Medicaid programs are administered by the Centers for Medicare and Medicaid Services (CMS). One hundred sixty-four health care experts were consulted regarding billions of tax payer dollars lost annually to Medicare and Medicaid fraud.
Among the recommendations:
1. States should receive a boost in federal funding for Medicaid fraud-fighting activities
2. Consistent use of provider enrollment policies
3. Examining Medicare payment policies which, through pricing differences, foster susceptibility to waste, fraud, and abuse
4. Balancing Medicare contractor incentives concerning overpayment findings with penalties for contractors whose findings are reversed via CMS administrative appeals procedures
5. Installing a clinical advisory panel to monitor CMS contractor activities
6. Identifying and eliminating state and federal Medicare/Medicaid anti-fraud programs.
7. Use of current CMS moratorium and mandatory compliance programs
“Bipartisan Finance Committee Members Release Recommendations to Combat Waste, Fraud & Abuse in Medicare & Medicaid.” Senate Finance Committee. http://www.finance.senate.gov/newsroom/chairman/release/?id=4e573856-e65f-49f5-ab73-1cb6bde47cc9. Website. January 31, 2013.
Revised on March 15, 2013