Stepped-up federal funding resulted in more seniors receiving training in how to stop Medicare fraud in 2012, but the latest annual survey of the $20 million program shows it produced $134,000 in actual savings.
Many illegal schemes rely on seniors who aren't savvy in how fraudsters and opportunists can use Medicare numbers to bill for care and equipment that is unneeded or never delivered. The Obama administration greatly increased the funding in 2010, 2011 and 2012 to bolster the so-called Senior Medicare Patrol program, which educates them with a branch in each U.S. state, plus Washington, D.C. and three territories.
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HHS' inspector general has unveiled a large red button on the Internet that will cost hospitals and drug companies thousands or perhaps millions of dollars if they press it.
Yet, press it they might. The OIG unveiled a new online portal this week for healthcare companies to turn themselves in for violating some of the harshest and most sweeping federal laws on healthcare, including the anti-kickback statute, the False Claims Act, and the Stark law. More than $280 million has been sent to the government through the 800 self-disclosures since 1998, averaging $350,000 per filing.
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Boehner
A week after the Obama administration announced a yearlong delay in the healthcare reform law's employer mandate, House Republicans are demanding that the White House explain why it hasn't extended the same reprieve to individuals and families.
“Healthcare costs are going through the roof. I think Sen. Baucus had it right—this is a train wreck,” House Speaker John Boehner (R-Ohio) said Tuesday during a news conference on Capitol Hill, referring to the Montana Democrat's limited remark about the implementation of health insurance exchanges.
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Instantaneous eligibility determination for exchange subsidies or Medicaid will not happen on Oct. 1 because of the Obama administration's decision to put off for one year requiring employers to report their employee health coverage, as well as a CMS-proposed rule published Friday loosening verification of individuals' income for the purpose of federal insurance subsidies.
In 2014, eligibility evaluations for premium tax credits and Medicaid eligibility will be based on the “honor system,” and will be performed manually by the state exchanges, rather than being based on IRS data provided to the exchanges through the new federal data hub. Experts say this will increase staff costs to manually determine eligibility. And it may increase fraud as well, thus costing the federal government more in premium subsidies.
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Healthcare fraud may be growing, but the number of fraud cops who work to stop it is shrinking.
The Center for Public Integrity reports that HHS' Office of the Inspector General, which generates an $8 return for every dollar invested in battling fraud, is shedding staff members by the hundreds because of recent budget cuts.
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