In a press statement last week, Senators Max Baucus (D-MT), Tom Carper (D-DE), Tom Coburn (R-OK), and Orrin Hatch (R-UT) called for Medicare program integrity improvements. Their statement was in response to a recent report by the Office of the Inspector General (OIG), which calls for more aggressive efforts to stop Medicare fraud and abuse before it occurs.
The bipartisan group of Senators called for stronger fraud detection processes within the Medicare Drug Integrity Contractor (MEDIC) program, which the OIG said is not doing enough to identify preventable cases of fraud.
Detecting Medicare fraud before it occurs is imperative to protecting beneficiaries, taxpayers and the Medicare program, which ensures access to healthcare for nearly 50 million Americans. Bipartisan support in the Senate for tougher policies is a significant step to strengthening fraud prevention efforts.
Action in the Home Health Community
A strong advocate for the prevention of Medicare fraud before it can occur, the Partnership has collaborated with other community leaders on a detailed proposal to strengthen the Medicare home health benefit by targeting waste, fraud and abuse within the system. The Skilled Home Healthcare Integrity and Program Savings (SHHIPS) proposal calls for such reforms as a more rigorous claims review process, stronger conditions of participation, and payment “guardrails” to prevent aberrant claims from being paid.
Program integrity reforms are key to reducing wasteful spending and protecting innocent beneficiaries from policy measures that could negatively impact senior care such as across-the-board cuts or increased copayments.
The Partnership is also a founding member of Fight Fraud First!, a collaborative effort of advocates for seniors, persons with disabilities, military veterans, and minority communities. The FFF! Coalition advocates that every effort should be taken to achieve savings by eliminating Medicare and Medicaid waste, fraud and abuse before any funds are taken from Medicare beneficiaries or the benefits on which they depend.