Among the hundreds of pages of the PPACA are passages addressing provider fraud, a far-too-common and far-too-costly issue that has long plagued the program.
The good news is, things seem to be getting better.
CMS just reported they recovered a record $14.9 billion in 2011 and 2012 from anti-fraud prosecutions and judgments. The number of providers kicked out of Medicare more than doubled in the two years after PPACA was passed. And the most recent large action saw 89 individuals charged with $223 million in false billing.
One occurred in Miami (shocking, I know), where a local TV celeb was busted for allegedly falsely billing Medicare some $20 million for home health care services for diabetics…(you gotta see this picture of the alleged perp…)
There are a bunch of reasons for the increased success;
- PPACA allocated an additional $350 million over ten years to anti-fraud efforts;
- the FBI has dedicated more resources to the effort,
- CMS investigations staff and resources have been increased and given more authority and a more prominent position in the Department;
- computer programs designed to identify potential fraud have been developed and improved, and
- rewards for tips may be drastically increased – up to a maximum of $9.9 million.
That’s all good – but every time I see a TV ad for that hoverround chair I think there’s still some rather significant “opportunities” to reduce taxpayers’ burden.
If those companies can afford to stuff my cable box full of adverts, they are making too much profit.