Senate health bill lacks teeth to tackle fraud

fraud doctorThe prospects for including strong anti-fraud provisions in health reform died early Sunday morning when Sen. Harry Reid released the final amendments to the bill.

Several proposed amendments were considered, including one by Sen. Al Franken (D-Minn.) we liked a lot. New anti-fraud provisions that did make into the final bill include a package by Sen. Ted Kaufman (D-Del.) that contains tougher criminal sentencing, tighter fraud definitions and expansion of the federal false claims act. All are worthy provisions, but they aren’t the game changers needed to turn the corner on fraud.

This is truly a missed opportunity by Congress to save taxpayers and insurance consumers a bundle of money. Adding some 30 million people to insurance rolls will enhance the opportunities to defraud, especially by organized rings. At some point down the road, Congress will recognize the fraud savings they had envisioned to pay for health care isn’t happening, and they will need to address it with much stronger anti-fraud remedies.

Let’s hope that happens sooner rather than later.

Insurance fraud goes YouTube

YouTube winnersStudents at Cortland State University in New York have created a clever way to demonstrate the high cost everyone pays for insurance fraud. In a YouTube video, the students created a scenario where an insurance consumer comes into an agent’s office to “buy” some insurance fraud. Through the dialogue we learn that the consumer will need to pay an extra $800 on top of what she already pays for coverage — and that fraud is an $85 billion a year business.

“Wow, you could like fund NASA for five years with that kinda money,” the young consumer replies. “Or send 12 million kids to college.”

The short, simple video gets the point across clearly. It was the winning entry in a student contest sponsored by the New York Alliance Against Insurance Fraud to promote anti-fraud awareness in the state. The young video producers — all communications majors — won $500 and a free trip down to New York City to attend NYAAIF’s annual meeting recently to premier their production.