Medicare antifraud efforts paying off, experts say

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President Barack Obama
President Barack Obama
Although Medicare's fraud detection tactics have been sharply criticized by lawmakers and provider groups, federal officials say efforts are paying off.
 
The number of Medicare Strike Force Teams operating in the United States has quadrupled under the Obama administration, National Public Radio reported Tuesday. And fraud experts say the $340 million Congress has devoted to fraud prevention over the next 10 years will keep law enforcement busy. Officials from the Centers for Medicare & Medicaid Services told NPR that the number of defendants facing healthcare fraud charges jumped sharply in the last year.
 
Patrick Burns of Taxpayers Against Fraud, an organization that helps providers sue fraudsters, describes the administration's approach as more “systematic” in fighting fraud than previous administrations.
 
"What we need to do is fund a war on fraud like we would fund a single day of a real war. If we do that, this country will straighten out real quick," Burns told NPR.
 
But long-term care provider groups say Medicare fraud patrols, such as Zone Program Integrity Contractors, unfairly target skilled nursing facility payments for therapy and rehabilitation. The American Health Care Association has said that ZPIC audits of therapy claims are the equivalent of “stealth policymaking.”
 
Medicare is expected to issue a report to Congress at the end of August detailing the number of new scams detected, and outline continuing efforts to prevent fraud.