The Medicare program is better protected from waste, fraud and abuse due to provisions of the Affordable Care Act. One of the fraud provisions in the law was inserted by Chairman Miller. Miller’s provision would require the Secretary of Health and Human Services to hold the initial reimbursement to a new durable medical device supplier (for example, new suppliers of canes, crutches, and wheelchairs) for 90 days while she determines if there is a significant risk of fraud. In October, 60 Minutes highlighted the issue of unscrupulous durable medical device suppliers that use “phantom patients” to get paid by Medicare for medical supplies never purchased. This provision will give Medicare investigators the time they need to determine whether the business is legitimate.
Today, the Department of Health and Human Services (HHS) announced steps it is taking to keep the Medicare program safe and secure. The Hill explained these new measures:
The White House applauded HHS’s work and reminded us all that these are among the reform provisions that congressional Republicans threaten to repeal:
Today, the Department of Health and Human Services (HHS) announced steps it is taking to keep the Medicare program safe and secure. The Hill explained these new measures:
“Healthcare providers would be subject to new screening measures based on their level of risk to federal health programs, under new proposed regulations released by the Centers for Medicare and Medicaid Services. The fraud, waste and abuse prevention measures were called for in the new healthcare reform law.
“The screening measures include database and licensure checks, unscheduled or unannounced site visits, even criminal background checks and fingerprinting for the highest-risk providers and suppliers to Medicare, Medicaid and the Children's Health Insurance Program. The proposed rule, which will be open for comment for 60 days, also establishes the criteria for six-month enrollment moratoriums to combat fraud and on payment suspensions during pending fraud investigations.”
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“Improper payments cost federal health programs about $55 billion a year. The White House piggy-backed off the announcement to make the case that defunding healthcare reform, as some Republicans in Congress are advocating, would increase fraud.”
The White House applauded HHS’s work and reminded us all that these are among the reform provisions that congressional Republicans threaten to repeal:
“But if some opponents of health reform in Congress get their way, these common sense rules will be stopped dead in their tracks.
“Opponents are threatening to defund the Affordable Care Act, which would effectively handicap implementation and enforcement of these new rules that would help crack down on criminals and protect seniors.
“This is just one example of the consequences of defunding the Affordable Care Act and one of the many reasons why we can’t afford to roll back the new law. If opponents of reform get their way, new anti-fraud policies aren’t the only provisions that will be prevented from moving forward.”
