DOJ and HHS Highlight Obama Administration Efforts, Health Reform Tools to Combat Medicare Fraud

At a Chicago summit highlighting a new high-tech war against health care fraud, Health and Human Services (HHS) Secretary Kathleen Sebelius and Attorney General Eric Holder recently discussed how the Affordable Care Act and the Obama Administration’s Health Care Fraud Prevention and Enforcement Action Team (HEAT) are helping fight Medicare fraud.  The Chicago summit is the seventh regional health care fraud prevention summit hosted by the Department of Justice and HHS.

“This Administration continues to move aggressively in protecting patients and consumers and bringing health care fraud criminals to justice,” said Attorney General Holder.  “Through HEAT, we have achieved unprecedented, record-breaking successes in combating health care fraud and as a result of the Affordable Care Act, we have additional critical resources, tools and authorities to continue this great success.”

 “We have a simple message to criminals thinking about committing Medicare fraud: don’t even try,” said Secretary Sebelius.  “Thanks to health reform and our Administration’s work, we have new tools and resources to catch criminals and stop Medicare fraud before it happens.”

 New tools provided by the Affordable Care Act are strengthening the Obama Administration’s efforts to fight health care fraud.  As a result of Affordable Care Act provisions:

- Criminals face tougher sentences for health care fraud, 20-50 percent longer for crimes that involve more than $1 million in losses;

- Contractors that police the Medicare program for waste, fraud and abuse will expand their work to Medicaid, Medicare Advantage and Medicare Part D programs;

- Government entities, including states, the Centers for Medicare and Medicaid Services (CMS) and law enforcement partners at the Office of the Inspector General (OIG) and the Justice Department, have greater abilities to work together and share information so that CMS can prevent money from going to bad actors by using its authority to suspend providers and suppliers engaged in suspected fraudulent activity.

A fact sheet with additional details about the Obama Administration’s efforts to combat health care fraud can be found at www.healthcare.gov/news/factsheets/2012/02/medicare-fraud02142012a.html.

http://www.justice.gov/opa/pr/2012/April/12-ag-429.html

About the Author

Reed Tinsley CPA

This article is written by Reed Tinsley, a Houston, TX-based CPA with over 30 years of experience advising physicians and medical practices across Texas and the United States. Reed holds certifications as a Certified Valuation Analyst (CVA), Certified Healthcare Business Consultant (CHBC), and Certified Financial Planner (CFP), specializing exclusively in the healthcare sector. He is a published author, nationally recognized speaker, and trusted advisor to physicians on accounting & tax, practice management, and financial planning. Schedule a Free Consultation.