HHS Secretary and the Attorney General hosted the Seventh Regional Health Care Fraud Prevention Summit on Wed Apr 4. At this Chicago summit highlighting a new high-tech war against healthcare fraud, HHS Secretary Kathleen Sebelius and Attorney General Eric Holder discussed how the Affordable Care Act and the Obama Administration's Health Care Fraud Prevention and Enforcement Action Team (HEAT) are helping fight Medicare fraud.
The regional summits bring together a wide array of public and private partners, and are part of the HEAT partnership between HHS and the Department of Justice to prevent and combat healthcare fraud. The Obama Administration's HEAT efforts have resulted in record-breaking healthcare fraud recoveries. In FY2011, for the second year in a row, the departments' anti-fraud activities resulted in more than $4 billion in recoveries, an all-time high. New tools provided by the Affordable Care Act are strengthening the Obama Administration's efforts to fight healthcare fraud. As a result of Affordable Care Act provisions: § Criminals face tougher sentences for healthcare fraud, 20-50 percent longer for crimes that involve more than $1 million in losses § Contractors that police the Medicare program for waste, fraud, and abuse will expand their work to Medicaid, Medicare Advantage, and Medicare Part D programs § Government entities, including states, CMS, and law enforcement partners at the Office of the Inspector General (OIG) and DOJ, have greater abilities to work together and share information so that CMS can prevent money from going to bad actors by using its authority to suspend payments to providers and suppliers engaged in suspected fraudulent activity On Wed Apr 4, the Obama Administration also announced more progress from its anti-fraud efforts, beyond the nearly $4.1 billion recovered last year: § In the early phase of revalidating the enrollment of providers in Medicare, 234 providers were removed from the program because they were deceased, debarred, or excluded by other federal agencies, or were found to be in false storefronts or otherwise invalid business locations § In 2011, HHS revoked 4850 Medicaid providers and suppliers and deactivated 56,733 Medicare providers and suppliers as HHS took steps to close vulnerabilities in the Medicare program § In 2011, HHS saved $208 million through pre-payment edits that stop implausible claims before they're paid § Prosecutions are up: the number of individuals charged with fraud increased from 797 in FY2008 to 1430 in FY2011 - nearly a 75 percent increase § In the first few weeks of enhanced site visits required under the Affordable Care Act screening requirements, HHS found 15 providers and suppliers whose business locations were non-operational and terminated their billing privileges § Through outreach and engagement efforts, more than 49,000 complaints of fraud from seniors and people with disabilities reported to 1-800-MEDICARE were referred for further evaluation § A recent redesign of the quarterly Medicare Summary Notices received by Medicare beneficiaries makes it easier to spot and report fraud The full text of this excerpted HHS press release (issued Wed Apr 4) can be found at http://www.HHS.gov/news/press/2012pres/04/20120404a.html. ________________________________ CMS.gov Website Upgrade CMS is in the process of making upgrades to the www.CMS.gov<http://www.CMS.gov> website. We appreciate your understanding and apologize for any inconvenience. ________________________________ Note: If you have problems accessing any hyperlink in this message, please copy and paste the URL into your Internet browser. If you know someone who would like to subscribe to a Medicare Fee-For-Service (FFS) provider listserv, go to (http://www.cms.gov/prospmedicarefeesvcpmtgen/downloads/Provider_Listservs.pdf). If you would like to unsubscribe from a specific provider listserv, please go to (https://list.nih.gov/cgi-bin/wa.exe?INDEX) to unsubscribe or to leave the appropriate listserv. Please DO NOT respond to this email. This email is a service of CMS and routed through an electronic mail server to communicate Medicare policy and operational changes and/or updates. Responses to this email are not routed to CMS personnel. Inquiries may be sent by going to (http://www.cms.gov/ContactCMS). Thank you.
