(June 8, 2010): For those of you who missed the first two dozen pronouncements (okay, perhaps a little exaggerated, but still . . . we got the message when Congress made it a False Claims Act violation to hold onto a mere overpayment for more than 60 days), President Barack Obama has again expressed his concern about health care fraud in a national Town Hall video teleconference with Senior Citizens across the country. He took this opportunity to further publicize his national campaign to combat fraud and misinformation regarding the Medicare program and the Affordable Care Act. President Obama has specifically ordered HHS to work to reduce the current Medicare improper payment rate. As the President reiterated, the current Administration is committed to fighting health care fraud. To that end, the following steps have been taken:
The President has directed HHS to cut the improper payment rate, which tracks fraud, waste and abuse in the Medicare Fee for Services program, in half by 2012.
The Administration has helped support a renewed partnership between the Federal government and state Attorneys General. Secretary Kathleen Sebelius and Attorney General Eric Holder today sent a letter to state Attorneys General urging them to vigorously prosecute criminals who seek to steal from seniors and taxpayers and pledged the support of federal officials for state efforts.
A nationwide series of anti-fraud summits hosted by the Departments of Justice and Health and Human Services will bring federal, state and local officials together with representatives from the private sector to discuss tactics to fight fraud. The first summit will be held in Miami with additional summits in Los Angeles, Las Vegas, Detroit, Boston, New York, and Philadelphia.
A redoubling of efforts by U.S. Attorneys nationwide to coordinate with state and local law enforcement to prevent and prosecute fraud. Today, Attorney General Holder called on U.S. Attorneys to hold regular forums with local officials to discuss how to better crack down on criminals who commit fraud.
Notably, the current administration’s focus on health care fraud enforcement is reminiscent of the major initiatives rolled out during the President Clinton’s terms in office. As you may recall, Attorney General Reno named "Health Care Fraud" as the Department of Justice’s "#1" white collar priority. While many voters tend to associate Republicans with "pro-law enforcement" and "anti-fraud" measures, the Democrats have clearly led in the area of health care fraud enforcement.
In any event, the message is quite clear – the current administration has been, and will continue to be, extremely aggressive in its efforts to identify and prosecute instances of health care fraud. Unfortunately, with recent changes to the False Claims Act and the Federal Anti-Kickback Statute, incidents that might have otherwise qualified as a mere overpayment may be viewed quite differently today by Federal prosecutors. Health care providers should diligently work to ensure that their operations, coding and billing activities fully comply with statutory and regulatory requirements.