Prior to the much hyped televised health care debate that took place on February 25, President Obama spelled out his objectives for health care reform. The plan would make health care more affordable, make health insurers more accountable, expand health coverage to all Americans, and make the health system sustainable in part by cracking down on fraud and abuse.

Among other initiatives, the proposal outlines a list of policies to curb fraud, waste, and abuse. As outlined, the waste and abuse plan would:

• Establish a comprehensive sanctions database,
• Require registration and background checks of billing agencies and individuals,
• Expand access to the healthcare integrity and protection data bank,
• Modify certain Medicare medical review limitations,
• Establish a CMS-IRS data match to identify fraudulent providers,
• Prevent delays in access to generic drugs,
• Limit debt discharge in bankruptcies of fraudulent health care providers or suppliers,
• Use technology for real-time data review,
• Study universal product numbers claims forms for selected items and services under the Medicare program,
• Increase liability of Medicare administrative contractors for claims submitted by excluded providers, and
• Add strong sanctions, including jail time, for individuals who purchase, sell, or distribute Medicare beneficiary identification numbers or billing privileges under Medicare or Medicaid.

 

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