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HHS on Monday announced a pilot program targeting fraudulent Medicare billings submitted by medical equipment providers in the Los Angeles area and South Florida, the Los Angeles Times reports. In addition to the two-year pilot program, which likely will be extended nationally if successful, HHS plans to fight fraud by strengthening requirements for new medical equipment dealers to obtain medical billing numbers. For example, company owners and managers will be required to undergo strict background checks. Moreover, current Medicare suppliers will be required to reapply to the program annually instead of every three to five years. HHS Secretary Mike Leavitt in an interview on Friday said, "We believe there are easily hundreds of millions of dollars that we can save and recover being lost from fraud and abuse." Leavitt said that he accompanied a fraud investigation task force to South Florida in May, where he visited a two-story office building that was the address for nearly 60 medical equipment providers. Leavitt said, "It was a long web of hallways with doorways on each side, and each would have a small marquee with a list of business hours and a contact number. But when I'd knock on the door, no one was there." Leavitt added, "There were hundreds of thousands of dollars being billed by these sham companies." Leavitt said that about 300 of the 1,500 dealers that the task force visited that week were barred from Medicare. Other fraudulent practices include paying low-income Medicare beneficiaries for their program numbers in order to bill the government for services that the beneficiaries do not need and were not prescribed, and providing prescribed equipment but billing Medicare for upgrades that are not received by beneficiaries. Kimberly Brandt, director of program integrity for CMS, said, "A lot of the ways the program is targeting fraud is by being very aggressive about having more on-site inspections" (Lauer/Leonard, Los Angeles Times, 7/2). "Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
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