Final Senate bill comes up fraud-lite
The final Senate health reform bill was released this evening — and for the fraud-fighting community, the 2,074-page proposal contains little in the way of “game-changing” provisions to curb health care fraud.
As expected, the bill crafted by Senate leadership carried over anti-fraud provisions from the Finance Committee proposal, but not the important elements from the measure developed by the Senate Health, Education, Labor & Pensions (HELP) Committee. The distinction is Finance ignored fraud perpetuated against the private sector while HELP embraced innovative ideas to encourage the government to collaborate with private insurers to fight a common enemy.
The fraud-fighting community pushed hard for provisions to enhance collaboration and data sharing among all entities combatting health care crime — whether it be federal, state or private insurers, even property/casualty carriers.
So now the bill heads to the floor of the Senate. Our last hope is the introduction of amendments to restore some of the strong anti-fraud provisions in the HELP bill. The next few days ought to tell whether such amendments materialize.
In the meantime, the Senate bill unveiled today does contain some useful Medicare anti-fraud measures including enhanced technology for fraud detection, an additional $100 million to combat fraud and greater authority to withhold payment from suspect providers. The bill also cracks down on shady entities selling bogus coverage by giving states more muscle to put these cons out of business.
Still, it’s disappointing the Senate leadership doesn’t see the value in taking an aggressive stand against health care fraudsters who are stealing anywhere from $68 billion to $220 billion each year, according to the FBI.
The fight goes on for now. Stay tuned.
