How does the federal government stop repeated Medicare fraud and abuse you might ask? Too often it does not. Sarah Jane Tribble reports for Kaiser Health News on Congressman Lloyd Doggett’s attempt to address this issue in Traditional Medicare.
After a Kaiser Health News investigation exposed how the Medicare and Medicaid systems were broken and not able to prevent repeat health fraud, Congressman Doggett introduced a bill to keep the fraudsters from continuing to bill Medicare.
The problem: The federal government has the authority to ban Medicare providers from the program for fraudulent or illegal behavior. But, these providers can circumvent the ban very easily in many cases. Why? The government relies on these fraudsters to be honest when reporting their criminal histories whenever they apply to offer Medicare or Medicaid services.
The government does not confiscate the national provider identifiers of fraudsters. The Centers for Medicare and Medicaid Services, which oversees Medicare and Medicaid, cannot take away people’s national provider identifiers, even when the government has banned them from these programs. The federal government has no authority to ban these providers from delivering services outside of Medicare and Medicaid, and the providers use these identifiers for those services as well.
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