Six Democratic senators who sit on the Judiciary Committee are pushing legislation they say would strengthen the hand of federal investigators and prosecutors in combating healthcare fraud.
Lawmakers seek to bolster anti-fraud efforts
The bill, titled the Health Care Fraud Enforcement Act of 2009, asks for an additional $20 million a year for the Justice Department through 2016, and makes a few adjustments to current laws that the senators say allow some fraudsters off too easy or limit the Justice Department's investigative reach. It was introduced by Sen. Ted Kaufman (D-Del.) and co-sponsored by Sens. Amy Klobuchar (D-Minn.), Herb Kohl (D-Wis.), Patrick Leahy (D-Vt.), Chuck Schumer (D-N.Y.) and Arlen Specter (D-Pa.).
The bill, for example, proposes tweaking sentencing guidelines so that courts must calculate the loss intended by healthcare fraud defendants as the amount billed to government programs, rather than the amount the government pays.
On the civil side, the bill would explicitly extend the False Claims Act to any Medicare claim tied to a kickback. In some cases, according to a bill summary issued by the sponsors, some hospitals have beaten lawsuits by arguing it's not their fault if they submit a claim for a procedure induced by a kickback the physician received—from a devicemaker, for example—allowing a wrongdoer's claim to be “laundered.”
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