WASHINGTON, D.C. – U.S. Rep. George Miller (D-CA) secured a provision in the health insurance reform legislation that will help to combat medical device fraud which costs taxpayers billions of dollars every year. 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.
“These con artists are stealing from the American taxpayer and putting Medicare’s future in danger,” said Rep. Miller, chair of the House Education and Labor Committee. “Health insurance reform passed today will take a big step to ensure these billions of dollars go to improve the health of our seniors and not into the pockets of criminals.”
“These con artists are stealing from the American taxpayer and putting Medicare’s future in danger,” said Rep. Miller, chair of the House Education and Labor Committee. “Health insurance reform passed today will take a big step to ensure these billions of dollars go to improve the health of our seniors and not into the pockets of criminals.”
By law, durable medical device suppliers who deliver them to Medicare
patients must be reimbursed within 15 to 30 days of submitting a payment
request. Often, companies that fraudulently bill Medicare for medical
supplies get reimbursed and close shop within 60 to 90 days before
Medicare detects fraud– what the FBI calls ‘pay and chase’.
Rep. Miller’s provision would require the secretary of health and human services hold the initial reimbursement to a new durable medical device supplier for 90 days when she determines there is a significant risk of fraud. This provision will give Medicare investigators the time they need to determine whether the business is legitimate.
The health insurance reform legislation contains critical provisions to improve Medicare and Medicaid’s fraud prevention by strengthening existing compliance and enforcement tools, raising penalties, and increasing resources to root out waste fraud and abuse.
Rep. Miller’s provision would require the secretary of health and human services hold the initial reimbursement to a new durable medical device supplier for 90 days when she determines there is a significant risk of fraud. This provision will give Medicare investigators the time they need to determine whether the business is legitimate.
The health insurance reform legislation contains critical provisions to improve Medicare and Medicaid’s fraud prevention by strengthening existing compliance and enforcement tools, raising penalties, and increasing resources to root out waste fraud and abuse.
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