Healthcare News May 3, 2012

  • OVERNIGHT HEALTH: Anti-fraud efforts win the spotlight

    Medicare fraud was in the headlines Wednesday as lawmakers sought new methods for combating abuse and the Obama administration touted a recent crackdown on false billings. 

    Concern about fraud in entitlement programs has intensified as Republicans seek low-hanging fruit for government cuts. 

    A bipartisan group of senators on Wednesday estimated that $20 billion to $100 billion is lost to abuse of Medicare and Medicaid. 

    The group, led by Senate Finance Committee Chairman Max Baucus (D-Mont.) and ranking member Orrin Hatch (R-Utah), solicited suggestions for fighting fraud in an open letter to the healthcare world.

    “To date, numerous efforts have been made to reduce fraud, yielding a mixed record of successes and failures,” the letter stated.

    “Drawing on the collective wisdom and accumulated insights of thousands of professionals … [could] potentially identify solutions that may have been overlooked or underutilized.”

  • Obama officials tout record ‘takedown’ by Medicare fraud force

    The Obama administration announced Wednesday it has charged 107 individuals for nearly $500 million in false Medicare billings.

  • Senators solicit ideas from healthcare industry on fighting fraud

    A powerful coalition of senators is asking for advice from healthcare providers on how to better fight Medicare and Medicaid fraud. 

    The bipartisan group, led by Senate Finance Committee Chairman Max Baucus (D-Mont.) and ranking member Orrin Hatch (R-Utah), published an open letter to the healthcare community asking for “suggestions and solutions” to address waste, fraud and abuse in the systems.

    The group noted that, between the two programs, fraud is estimated to cost at least $20 billion and up to $100 billion.

    The letter highlighted payment integrity and enforcement as two areas that would benefit from “input.”

    “To date, numerous efforts have been made to reduce fraud, yielding a mixed record of successes and failures,” the letter stated.

    “Drawing on the collective wisdom and accumulated insights of thousands of professionals and individual experiences could offer a fresh perspective and potentially identify solutions that may have been overlooked or underutilized.”

    The effort includes Sens. Tom Coburn (R-Okla.), Ron Wyden (D-Ore.), Chuck Grassley (R-Iowa) and Tom Carper (D-Del.) in addition to Baucus and Hatch.

    It is addressed to “all interested stakeholders in the healthcare community,” the letter stated, asking for “succinct and concrete” white papers by June 29.

    “Together, we believe we can improve program integrity and be better stewards of taxpayer dollars,” the senators wrote.

  • Embattled medical debt collector to bar media from shareholder meeting

    A leading collector of medical debt, under fire from lawmakers for allegedly shaking down patients, will not allow members of the press at its annual meeting for shareholders Wednesday.

    The meeting comes a week after reports alleged that Accretive Health embedded employees in hospital staffs to more easily pressure patients to settle bills.

    Accretive employees discouraged some people from seeking emergency care altogether, according to one report, which cited an investigation by the Minnesota attorney general’s office.

    Accretive has consistently denied the allegations as a “flagrant distortion of fact,” but saw its shares tumble amid the backlash nonetheless.

    The firm went public in 2010 and has held one shareholder meeting since. It was also closed to press, a spokeswoman told the Chicago Tribune.

    Two federal lawmakers — Sen. Al Franken (D-Minn.) and Rep. Pete Stark (D-Calif.) — have expressed concern about Accretive’s alleged practices.

    “This is corporate greed at its worst, abuse of patients’ rights to dignity and privacy, and, I believe, a possible violation of several laws,” Stark said in a statement April 26.

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