Sen. William Cohen of Maine, ranking Republican member of the Senate Special Committee on Aging, last week called for stronger federal laws against healthcare fraud and abuse, including a fivefold increase in the penalties for fraudulent billing.
He also criticized the House of Representatives for balking at putting his anti-fraud measures in the crime bill that is soon to be debated on the floors of the House and Senate.
"I understand that the House is resisting putting this in the crime bill because the (Clinton) administration wants to put it in the healthcare reform bill to use the savings to pay for new programs," Mr. Cohen said. "However, the healthcare bill may never pass, and every day we wait costs the taxpayers millions."
The Senate already has passed the measures Mr. Cohen is seeking in its version of the crime bill. However, the House did not include them in its version. The two chambers are working to reconcile the two versions of the bill.
Mr. Cohen made his remarks in conjunction with the release of a study completed by the Republican staff of the Aging Committee that detailed 50 separate types of scams used to defraud Medicare and Medicaid.
According to estimates by the General Accounting Office, more than $103 billion will be paid by Medicare and Medicaid in 1994 for fraudulent claims. Among the measures called for by Mr. Cohen were:
Increasing the penalties for fraud and abuse. For example, Mr. Cohen recommends raising the penalty for submitting false claims to $10,000 from $2,000 per occurrence.
Establishing an all-payer fraud-and-abuse trust fund that would finance enforcement activities.
Establishing a national healthcare fraud database to better track actions taken against providers.
Allowing private-sector health plans to take civil actions against fraudulent providers.