A Senate bill aimed at preventing Medicare fraud with real-time claims audits and other measures has the endorsement of the American Association for Homecare, a trade group representing makers and suppliers of durable medical equipment.
DME trade group backs anti-fraud legislation
The Prevent Health Care Fraud Act of 2009, introduced by Sen. George LeMieux (R-Fla.) calls for the government to hire a contractor with experience in the financial services industry to create and implement a system that employs predictive modeling, comparing claims as they come in against historical transaction data to identify statistical anomalies and patterns that indicate fraud, waste and abuse.
Schemes involving fraudulent DME claims have been rampant, particularly originating from South Florida, Los Angeles and a few other areas, and the association said in a written statement that the bill is consistent with its contention that the CMS should do more to keep criminals out of the program rather than chase them after bogus claims have been paid.
The bill would establish a deputy HHS secretary for healthcare fraud prevention, who would be authorized to withhold payment for suspect claims until they're verified. It also would require more scrutiny of providers before they're allowed to participate in federal health programs.
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