Joint HHS/DOJ Effort Recovered $4 Billion
U.S. Senator Sheldon Whitehouse today commended the joint efforts of the Department of Health and Human Services and the Department of Justice to crack down on fraud and abuse in America's health care system. A report released Monday showed that the joint effort resulted in the recovery of more than $4 billion in taxpayer dollars in fiscal year 2010.
"As we continue working to address our long-term budget deficit, identifying and attacking cases of fraud in our health care system is more important than ever," said Whitehouse, who has supported several legislative efforts to strengthen federal authority to fight back against fraud. "And with the announcement of new rules authorized by the Affordable Care Act to supplement fraud prevention efforts, I'm confident we can continue to protect taxpayer dollars and ensure that our health care system is working for American families."
Last year, Senator Whitehouse cosponsored and worked on bipartisan Medicare fraud-fighting legislation that was signed into law as part of the Small Business Jobs Act in September. The law requires Medicare to adopt state-of-the- art technology -- predictive modeling systems currently used by the credit card and banking industries -- to identify fraudulent claims and billing patterns before taxpayer funds are spent. This year, the new system will roll out in 10 states with the highest levels of waste, fraud, and abuse. By the third year of implementation, predictive modeling software will be incorporated into Medicare claims processing systems nationwide. The law signifies an important shift from Medicare's current "pay and chase" model towards one that prevents fraud from happening in the first place.
Whitehouse also co-sponsored the Fraud Enforcement and Recovery Act, which was signed into law in 2009. That law provided additional tools for fighting fraud, including extending federal fraud laws to private mortgage brokers and bringing options and derivatives within the criminal securities fraud statutes. The law also made a number of reforms to the False Claims Act (FCA) to make it easier for private plaintiffs to bring fraud suits on behalf of the government, and for government attorneys to investigate cases. And the law established the Financial Crisis Inquiry Commission, which is scheduled to release its report on the financial crisis later this month. Finally, FERA provided additional resources for fraud prevention, investigation, and enforcement.
Today, Whitehouse will participate in a Judiciary Committee hearing examining ongoing challenges in the fight against fraud.