Senators seek May deadline for HHS fraud-fighting reports

The data will ensure transparency and accountability for Medicare and Medicaid in the battle against health care fraud, a letter to HHS states.

By Alicia Gallegos — Posted April 11, 2011

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Congressional leaders have asked for a May 20 deadline for the Dept. of Health and Human Services to start providing quarterly reports detailing its anti-fraud efforts.

Sens. Max Baucus (D, Mont.) and Orrin Hatch (R, Utah), the leaders of the Senate Finance Committee, proposed the time line during a March 2 hearing at which HHS officials discussed new fraud prevention tools. In a follow-up letter to HHS, the senators asked that the reports detailing the agency's fraud-fighting efforts in Medicare and Medicaid include data, benchmarks and updates on ongoing fraud cases as well as any money saved. The updates will ensure transparency and accountability in the government programs and safeguard taxpayer dollars, the senators said.

"Our efforts to crack down on fraud will only improve with the right information and data," Baucus said in a statement. "We need to stay ahead of the criminals who defraud taxpayers out of tens of billions of dollars each year, and these reports will provide a valuable measuring stick that will go a long way to protect Medicare and Medicaid."

Don White, a spokesman for the HHS Office of Inspector General, said his agency had received the senators' letter and was reviewing the request. At this article's deadline, HHS had not issued a formal response to the letter. In an email, OIG said meetings during the next two weeks would determine the agency's next steps on the issue.

The Obama administration has faced criticism by some lawmakers who question its fraud-fighting success. In December 2010, Sen. Charles Grassley (R, Iowa) said the Dept. of Justice's accomplishments were declining based on an analysis by his office that found fraud conviction rates in 2009 decreased by 18%.

In January, however, HHS announced an unprecedented $4 billion in recovered fraudulent payments in 2010, its most successful year battling fraud. The anti-fraud efforts included 1,116 criminal investigations, 931 defendants charged and 726 convictions, according to the HHS annual report.

In his statement, Baucus cited the funds recovered in 2010 and said the recovery will be "even higher in the future" with the help of new fraud-fighting tools included in the national health system reform law.

The law establishes new ways for Medicare to screen health care professionals before enrolling them in the program, and authorizes a billing database that HHS officials say will enable better coordination and information sharing. The law also increases civil and criminal penalties for offenders and increases funding for the Health Care Fraud and Abuse Control Program, a joint effort between the Dept. of Justice and HHS.

"Waste and fraud within Medicare and Medicaid is costing taxpayers billions," Hatch said in a statement. "This is unacceptable -- especially at a time when our budget deficits are soaring and more Americans are relying on Medicare and Medicaid."

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