HHS Secretary Mike Leavitt today asked members of Congress for $183 million in discretionary fiscal 2008 spending to better assist the departments anti-fraud and abuse efforts, especially in the Medicare prescription drug program, Medicare Advantage and Medicaid. Overall, the Bush administration has asked for $1.3 billion for the Health Care Fraud and Abuse Control program, which is run by HHS and the Justice Department.
On Capitol Hill, Leavitt also told members of the House Budget Committee that money recouped from companies that fraudulently bill Medicare should go back to the agency rather than the Medicare trust fund, which current law requires. Though its unclear how much money that would be, the secretary said that Congress could expect to see a return of up to 15 times the amount at which they fund the program.
In South Florida alone, an investigation found that 31%, or 491 of 1,581 durable medical equipment suppliers were not meeting basic Medicare participation requirements, Leavitt said. Those same suppliers last year billed Medicare almost $300 million, with about one-third of the money allowed and with Medicare paying some $89 million to cover the claims.
Leavitt called the rampant abuse one of the most discouraging things I have observed in public life.
Meanwhile, HHS announced a two-year initiative to further protect Medicare beneficiaries from fraudulent home-health providers. Under terms of the program, the CMS will require home-healthcare providers who operate in the greater Los Angeles and Houston areas to immediately resubmit applications to be considered a qualified Medicare home health agency. Those who do not reapply within 30 days, have failed to report an ownership change, have senior managers or employees who have committed a felony, or that no longer meet each of the requirements for enrollment, will have their Medicare billing privileges revoked.
Over the past year, the CMS has deemed those locations to be hotbeds for home-health agency problems. -- by Matthew DoBias