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Senators ask providers to weigh in on fraud prevention


By Joe Carlson
Posted: May 2, 2012 - 12:15 pm ET
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A bipartisan group of six lawmakers from the Senate Finance Committee issued an open letter to healthcare providers, payers and patients seeking input on better ways to prevent waste and fraud in healthcare, including ideas on improving the current audit system for alleged overpayments.

The letter highlights estimates that between $20 billion and $100 billion a year are lost to fraud and misspending in Medicare, Medicaid and other federal healthcare programs. The committee members are asking interested parties to submit by June 29 detailed whitepapers on ways to reduce fraud and improve the current “program integrity efforts.”

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Kimberly Brandt, chief healthcare investigative counsel for the Senate Finance Committee, said at an industry conference Tuesday that the committee would welcome feedback on, among other things, the controversial system of overlapping federal contractors that conduct independent investigations in fraud and payment errors, including Zone Program Integrity Contractors and Recovery Audit Contractors.

The committee is also seeking input on ways to reform federal payment systems to improve accuracy and efficiency of reimbursements, and for fraud and abuse reforms “to ensure tougher penalties against those who commit fraud.”

"To date, numerous efforts have been made to reduce fraud, yielding a mixed record of successes and failures," the letter says. "We believe federal efforts would be strengthened by input from members across the healthcare community—providers, payers, health plans, contractors, non-profit entities, consumers, data analytics entities, governmental partners, and patients."

The senators who signed the letter were Finance Committee chairman Max Baucus (D-Mont.), Ranking Republican Orrin Hatch (Utah), Dr. Tom Coburn (R-Okla.), Ron Wyden (D-Ore.), Chuck Grassley (R-Iowa) and Tom Carper (D-Del.).


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