Grappling with Billions in Medicare Fraud, Senators Propose the Stop Scams Act of 2014 By Tod Aronovitz | 06/03/14 | 0 Comment

On our ARONOVITZ LAW Blog on April 17, we discussed the frustrating conclusions that came out of a recent Senate hearing by the Special Committee on Aging.

The committee estimated that healthcare fraud costs taxpayers $60 billion to $90 billion each year. And although notable progress has been made, including 377 prosecutions in fiscal 2013, Committee Chairman Bill Nelson, D-Fla., called for more anti-fraud enforcement measures and more resources to stop criminals from taking advantage of the Medicare program and its patients.

Now a bi-partisan group of senators is proposing legislation that will make it easier for medical providers and insurance companies to spot scammers, according to a recent McClatchy Washington Bureau story.

Led by Nelson, whose home state of Florida is often described as “ground zero” for Medicare fraud, the group has put forward recommendations to free up some of the rules so that insurers and other medical providers can share information that will more quickly identify fraudsters and make sure they can’t do it again.

Nelson took to the Senate floor on May 20 to speak about the committee’s thorough assessment of the widespread fraud that occurs in the Medicare program.

“To combat this fraud, it’s going to be one of the core missions of our Aging Committee,” Nelson said in the article.

His co-author on the bill is Republican Sen. Susan Collins of Maine. Additional sponsors include Democratic Sens. Tom Carper of Delaware and Bob Casey of Pennsylvania, as well as Republican Sen. Chuck Grassley of Iowa.

Their bill, called the Stop Scams Act of 2014, proposes to:

  • Allow private insurers to share their knowledge about potentially fraudulent providers with each other and with Medicare.
  • Set up screening to determine if providers ever held ownership in organizations that defrauded Medicare, and if so, they would be blocked from starting up a different company.
  • Require full end-to-end testing of new medical diagnostic codes so that fraud prevention systems work accurately and payments to providers aren’t delayed.
  • Permit the Medicare Payment Advisory Commission to make recommendations for checking fraud, while requiring the panel to come up with a way of estimating how many tax dollars are lost to fraud each year.

How to Report Miami Medicare Fraud

Healthcare professionals or medical billing employees who have knowledge of questionable Medicare billing practices can file a confidential legal claim under the False Claims Act. By acting as a “whistleblower” in what is known as a “qui tam” lawsuit, a private party may collect between 10 to 30 percent of the amount recovered, depending on how the case is prosecuted.

ARONOVITZ LAW: Miami Whistleblower / Qui Tam Law Firm

The Miami Qui Tam law firm of ARONOVITZ LAW routinely works with whistleblowers to document Medicare fraud and other forms of fraud against the government. Contact Miami Whistleblower / Qui Tam lawyer Tod Aronovitz to discuss your case.