Sen Ted Kaufman (D-Del), a member of the Senate Judiciary Committee, introduced the Health Care Fraud Enforcement Act of 2009 (S 1959), according to an announcement on the Senator’s Web site. The legislation would further strengthen the government’s capacity to investigate and prosecute waste, fraud, and abuse in both government and private health insurance.
The act is co-sponsored by Committee chairman Patrick Leahy (D-Vt) and Committee members Arlen Specter (D-Pa), Herb Kohl (D-Wis), Chuck Schumer (D-NY) and Amy Klobuchar (D-Minn), and builds on the fraud-prevention efforts included in the Finance and Health, Education, Labor and Pension (HELP) committees’ health care reform bills.
“Fraud perpetrated against both public and private health plans costs between $72 and $220 billion annually, increasing the cost of medical care and health insurance and undermining public trust in our health care system,” said Senator Kaufman on the Senate floor. “We all know that rooting out waste, fraud, and abuse, in both government and private programs, is critical to making health care reform work. The Finance and HELP committees have worked long and hard to find ways to bend the cost curve down. …. There’s more work to be done, however, and the Health Care Fraud Enforcement Act is an important part of that effort.”
The bill makes calls for improvements to the federal sentencing guidelines, to health care fraud statutes, and to forfeiture and money laundering statutes. These improvements would:
• Direct the Sentencing Commission to increase the guidelines range for health care fraud offenses and clarifies that the full potential scope of the fraud should be considered at sentencing.
• Include all health care crimes within the definition of “health care fraud offense,” regardless of where they are codified. (ERISA, drug marketing, and kickback crimes are currently not included.) This change will make available to law enforcement the full range of antifraud tools, including criminal forfeiture and obstruction penalties, to combat these offenses.
• Clarify that all payments made pursuant to illegal kickbacks are false for purposes of the False Claims Act.
• Restore the original intent of Congress that a person is guilty of a health care offense if he knowingly does what the law forbids.
• Authorize a modest, yet significant, increase in federal antifraud spending of $20,000,000 per year through 2016.