AG wants 'aggressive' pursuit of Medicare 'fraudsters,' despite reluctance to join whistleblower cases

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New research from AARP shows Medicare loses $60 billion each year to fraud or waste, an estimate Attorney General Jeff Sessions said may be too low.

The amount lost to Medicare fraud in 2017 nearly equaled the budgets for Homeland Security and NASA combined, AARP found.

But when the senior advocacy organization asked Sessions whether Medicare ought to shift to a pre-approval payment model, the AG drew the line.

“Since Medicare pays over a billion claims each year, such a review process could end up delaying payments to legitimate and law-abiding providers, and possibly affect the delivery of critical services to Medicare beneficiaries,” Sessions told the AARP Bulletin. “Given that, the Department of Justice should continue aggressively pursuing healthcare fraudsters, either criminally or civilly, and holding them accountable to the fullest extent of the law.”

His comments come even as the Justice Department has declined to join — or withdrawn from — some high-profile whistleblower cases alleging fraudulent billing.

Two of those cases included false claims allegations against HCR ManorCare.

“Maybe our traditional systems aren't aggressive enough,” Sessions said. “A lot of the cases are hard to bring. They take a lot of time. When you look at it overall, it is billions of dollars at stake.

Observers have also said several recent federal rulings have made false claims cases more difficult to pursue.

Meanwhile,Sessions' boss, President Donald Trump, also has scaled back enforcement and penalties in resident harm cases, drawing the protest of some federal lawmakers.