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Rep. John D. Dingell

Rep. John D. Dingell

Posted: September 22, 2010 08:45 AM

On Thursday, the quality of life for millions of Americans will improve. That's the day the Patient's Bill of Rights takes effect, and on that day insurance companies:

  • Can't drop your coverage when you get sick;
  • Can't discriminate against kids with pre-existing conditions;
  • Will begin allowing young adults to stay on their parents' plans up to age 26;
  • Must end lifetime limits on coverage and face restricted annual limits;
  • Provide in new plans free preventive care like mammograms and immunizations;
  • Allow in new plans for a better appeals process on claims;
  • Will give enrollees in new plans the right to choose their own doctor.

These are all important modifications that will increase the quality of health care for millions of Americans. Notice what has happened with Medicare Advantage plans because of health reform -- a new Centers for Medicare and Medicaid Services (CMS) report shows in 2011 the cost of those plans will drop while the services offered will improve. As we see the benefits of reform already helping people's physical and economic well-being, there is another, less obvious part of the new law that will also reduce our budget deficit and save Americans billions of dollars: an unprecedented effort to crack down on waste, fraud and abuse.

A Thomson Reuters study estimates the U.S. health care system wastes around $700 billion a year. Fraud and abuse account one-fifth, between $125-$175 billion of that waste. Criminals who raid these programs, not only steal from taxpayers, but they do so at the expense of American seniors and families.

A crackdown on the scoundrels behind Medicare and Medicaid fraud will help cover the costs of health reform, allowing us to keep the services so many American rely on AND reduce the deficit. The Congressional Budget Office estimates that every $1 invested to fight fraud yields approximately $1.75 in savings.

Today, the Health Subcommittee of the Committee on Energy and Commerce, on which I serve, will hear from representatives from Health and Human Services (HHS) and CMS on cutting waste, fraud and abuse in Medicare and Medicaid. Their work is critical to both health reform and the future of the U.S. economy. And the new health care reform law will help us catch crooks with more than 30 new provisions to boost the efforts of CMS, Health and Human Services' Office of the Inspector General (OIG) and the Justice Department. I've worked for years to help investigators in their work. Now, we have a law with teeth and it might scare some bad actors from trying to rob elderly and impoverished Americans.

These reforms include a tactical shift by law enforcement. Right now, pursuit of the perpetrators begins only after the check has gone out, known as "pay and chase." The new law is designed to keep con artists out of the program before they ever get in. By utilizing enhanced background checks for providers, new disclosure requirements and on-site visits, our watch dogs will catch many phonies before the scam ever starts. The new law also requires:

  • Stronger rules and sentences for people who commit healthcare fraud;
  • Better screening tools to prevent fraud from happening;
  • Requirements for providers and suppliers to establish plans on how they will prevent fraud; and
  • Enhanced data collection that allows CMS, DOJ, states and other federal health care programs to share information.

Putting muscle behind our top cops does work -- and Southeast Michigan is proof. This July, the work of the Medicare Fraud Strike Force led to the arrests of 94 people who defrauded the Medicare system. Two of these scam artists were from Detroit and were convicted in a $2.3 million fraud scheme. These people not only broke the law, but they took advantage of the most vulnerable members of our society -- the elderly and poor -- and harmed the programs that are vital to our community.

We have always said an overwhelming majority of Americans citizens will benefit from health care reform, but these reforms will hurt one sector -- crooks and cons. The time for exploiting our system is over.

 
 
 
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12:04 PM on 09/25/2010
But why did it take Obamacare do do the obvious?
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Raymond Foret
09:51 PM on 09/23/2010
We need severe punishment for perpetrators of Social Security and Medicare fraud. The revolving door of our judicial system is a farce. Not until a few of these miserable people and corporations spend 25 years AT HARD LABOR IN PRISON will we begin to get control of this fraud. I do believe the republicraps will fight tooth and nail to defeat this legislation too.
03:57 PM on 09/23/2010
Hopeful but extremely skeptical that we can get a handle on this massive fraud. I worked in health care regulation in South Florida (Miami) in the 80's and 90's. Medicare fraud in particular was rampant and as I understand it, it remains so. Why this area predominantly? A "banana republic" culture with thousands willing to sell their Medicare numbers so fraudulent claims could be filed along with a weak and ineffective federal government response. Obama et. al., are not incorrect-- if we can effectively halt a majority of Medicare/Medicaid fraud, we will literally save hundreds of millions in precious health care dollars.
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Damiano Iocovozzi MSN NP
01:49 PM on 09/23/2010
The US still spends 1.2 trillion USD on end of life care that is medically futile. The country's ICUs are high tech hospices where $10,000 per day per patient are spent along with countless useless consultants ordering every lab, diagnostic, surgery, treatment et al which actually hasten death and serve no useful purpose, accomplish no medical goal and torture loved ones. The sane alternative is hospice care at home which costs $100-450 per day until natural death where the over-riding goal is comfort care and maximizing quality of life, not the number of days. Please visit my web page for lots of free information about sane alternatives to the insane American way of finishing one's days. There are lots of free podcasts and some TV shows you can watch soonerorlaterbook.com
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Morgan378
12:34 PM on 09/23/2010
I've been reporting an* reporting the charge o* a wheelchair on my Me*icare sheet! Now when I must have one I can't GET IT!!! I "have one" alrea*y! NO I HAVEN'T!!!! Maybe now they'll listen to me! Watch, now they'll be the one's to put me in jail reporting what I've been reporting *or 2 1/2 years! Sure! I'm the one who committe* a crime! They also kept paying *or oxygen treatment I wasn't receiving! Only threatening the company was I able to get them to stop! I might be unable to contribute to society *or the time being - but I can certainly ensure not a penny is spent on me that's unnecessary. They shoul* start listening to their members - much o* the complaints are alrea*y there. No nee* to investigate with all the complaints alrea*y put in. Where have they been up to now?! I'm not the only one bringing it to their attention - we are legion.
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Lilli917
a little peace and quiet please.
01:01 PM on 09/23/2010
You are absolutely doing the right thing by reporting this and hopefully there will soon be better tracking of these complaints. I would guess that your problems are seen as small compared with the huge violations they are dealing with and you are probably not at the" top of the list". I'm sure it's infuriating for you - keep trying. Please realize that much of the fraud being investigated amounts to one "fake doctor" billing thousands of dollars a day from a storefront or a car wash using stolen Medicare or Medicaid numbers. There is currently not a very well funded fraud investigation department and they are overwhelmed. I have reported cases where something similar is happening to a patient and they did eventually get it cleared up. Good Luck....
02:24 PM on 09/23/2010
THAT'S WHAT I SAY. good luck you can report on this all you want . the only people that get it is the tax-payers. they like politicians let way to much side by. because they don't have SPECIAL INTERESTS!!!!!!! get rid of lobbyist know...............
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Jean Clelland-Morin
religion / the Golden Rule
11:04 AM on 09/23/2010
Yes, severe punishment for those who abuse the health-care sytem. But there is another kind of abuse - the abuse of the body. We need to have heavy education/ propaganda to teach citizens (starting with children) to instill healthy lifestyles. // Jean Clelland-Morin
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MJinCanada
Safe from zombies until my 2nd cup of coffee
02:59 PM on 09/23/2010
Well, then you need more money into the education system for better school lunches, phys ed programs and playgrounds for recess -- all of which tend to be cut when times are tough.
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johnminehan
10:40 AM on 09/23/2010
What is fraud and abuse? PPACA legislatively overrules one of the case the OIG usually cites in Advisory Opinions, which states you have to intend to secure a kickback rather than to intend the action itself to be liable under AKS. How does this help?
10:12 AM on 09/23/2010
More smoke and mirrors, bread and circus.
Back in the '90's, Janet Reno and FBI Director Freeh started holding rallies in football stadiums to teach Medicare recipients how to turn in their docs for a $1000. The FBI and Office of the Inspector General started raiding Dr's offices and hospitals with guns in hand. The Social Security Act of 1997 gave us "HIPAA" and empowered anyone working for the Secretary of Health and Human Services the right to write their own subpoenas and copy anything in the doctor's office - including going so far as to arrest one woman for refusing to open her desk drawer.

In 1995, it was estimated that it took over 2200 hours a year to keep up with changing Medicare regulations. Which may be why a sting by the AMA found that Medicare offices only gave callers correct information 15% of the time -- and 50% of the time, following the official's advice would risk fines and prison.
10:42 AM on 09/23/2010
Better to do nothing at all about all those wheelchair bills for dead people than to try to capture thieves and limit fraud, after all, what does the government know about law enforcement? Double billing is just a clerical mistake after all, why force a provider to make sure his billing system isn't defrauding the taxpayer?
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johnminehan
12:23 PM on 09/23/2010
Spoken like someone who does not work with this. CMS is usually pretty good at seeing that most things are not fraud. The rules are arcane and errors are frequent.
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johnminehan
12:19 PM on 09/23/2010
Look at the bright side, for some of us, that 2200 hours is billable.
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09:57 AM on 09/23/2010
A crackdown on scoundrels and criminals who steal from the system sounds good to me. I wonder, though, how many providers who are simply overworked and understaffed, who may not cross all the Ts and dot all the Is, and get the right paperwork in the right file, will be caught in this dragnet.

Perhaps a better solution, that would eliminate a layer of regulatory bureaucracy, would be to simply have the government provide health care. This way, health care providers will be directly accountable to the people and financial oversight will be simplified.
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MJinCanada
Safe from zombies until my 2nd cup of coffee
03:05 PM on 09/23/2010
That's probably one of the reasons Canadian health care costs less. There's less overhead in general, but it's got to be harder for doctors to invent patients or bill for dead ones, or for people to go to doctor after doctor for prescriptions that could be sold on the street, because somewhere in the system a computer will flag it.
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11:15 AM on 09/24/2010
Really good point on the doctor shopping and prescription drug abuse. Here in the U.S. we spend far too much money investigating and prosecuting doctors for "overprescribing" pain killers. Some are unscrupulous pushers. But many are competent pain management physicians who live in fear of the DEA raiding their offices if they do too much to help their patients. A single, standard system could help eliminate "Dr. Feel-goods" and save a lot of money on drug enforcement in the process.
09:31 AM on 09/23/2010
What this enforcement cheerleader fails to include in his calculations is the increased cost of compliance to 99+% of healthcare providers who are honest. And the smaller the provider, the more onerous the cost of compliance.

This will provide an entire new industry for cop-types who get off on harassing their betters and behaving anyway they choose without answering to anyone but themselves.
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10:13 AM on 09/23/2010
You make an excellent point about compliance costs. Basically, what this means is hiring a compliance officer and adequate support staff to handle the additional paperwork load. Many providers try to make do with the staff they have, which leads to health professionals spending hours on paperwork instead of on patients, or otherwise working uncompensated overtime to meet the needs of both patents and bureaucrats. Bccause, after all, what we want are a lot of tired and cranky health care workers. Right? Right?
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johnminehan
12:25 PM on 09/23/2010
Sometimes you CAN make it back on less rejections by payors. Also, a GOOD compliance program is not necessarily an EXPENSIVE compliance program. It can be as simple as having a good accountant and lawyer to look at the tricky things.
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Hopeforu
12:24 AM on 09/23/2010
Now Health Insurance Companies are actively not covering Children at all to get out of covering children with preexisting conditions! Bas#$%&s!
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Lilli917
a little peace and quiet please.
12:44 PM on 09/23/2010
I think they are covering children who are on family plans. As I understand it, the current reports are of companies who refuse to just cover children and not their parents.
11:36 PM on 09/22/2010
True reform would be to conduct a physical, face-to-face meeting with every recipient of a Social Security check, Medicaid and Medicare coverage. It might take 5 years to do so the first time - which would put a million to work - but it's easy to believe that at least 15% of those recipients don't deserve it or are deceased.
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Darwan Winkler
Where's the Jobs!
06:57 AM on 09/23/2010
So true George! Reform will take time to felt and fully understood by the American people. The benefits of these "reforms" will be slow to recognize unless they affect you personally in someway.

Let face it, if you or a loved one is not "ill" and needing in someway, it's purely academic .
10:36 PM on 09/22/2010
I hope the Congressman will also get tough on the biggest healthcare fraud perpetrator and abuser of all: the Department of Veterans Affairs. Unexplained deaths (Marion and North Chicago, IL), un-sterilized surgical equipment at dozens of VA hospitals, thousands infected with HIV and hepatitis! If this (the VA) is the best healthcare system in the world, as advertised by Mr. Obama when he was pushing for his healthcare reform, then we are all screwed. Please Congressman, don't forget about us, your veterans.
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jstrate
08:44 PM on 09/22/2010
These reforms are all good. Finding Medicaid and Medicare fraud will not be easy. How do you go about auditing thousands of health care organizations and other providers in a system based upon greed and profit? To many patients, the bills are opaque. Is there enough budget to hire all of the auditors, lawyers, prosecutors and judges to deal with it all? Hospital accreditation, while not a joke, puts a private organization (JCAHO) in charge of determining whether or not these health care organizations will receive governmental payments. It sure looks like a case of regulatory capture, with 99% of them receiving accreditation. Would a government agency do a better job? I don't know.
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10:39 PM on 09/22/2010
People have been contacting Medicaid and Medicare offices repeatedly for years to inform them of fraud and they did nothing to stop it. They're not talking about chasing an extra aspirin on the bill, they're talking about non-existent offices billing for elderly who's identity they're using as patients. There's massive fraud going on. I've heard of this for 15 years now.
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Lilli917
a little peace and quiet please.
11:05 PM on 09/22/2010
It's not that complex. When you get your periodic listing of things that have been submitted to Medicare in your name, look at it and see if it actually makes sense and somewhat resembles work you have had done or treatments received. There are people who obtain Medicare numbers and put monthly or weekly charges on them. If you haven't been sick and there is billing for $50,000 on your bill for the past thirty days, you need to call the Medicare offices and report this. It's time for each of us to spend a few minutes and review these bills. In many cases Medicare is billed from an address that is just a storefront or car wash and making $20,000 to $30,000 a day. There are offices now where you can report this type of fraud, but too many people feel like they can't be bothered.
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cwcarman
07:19 PM on 09/22/2010
If we put all the doctors,hospitals and medical supply corporations in jail for cheating on Medicare, we would have a shortage of care, beds and a lot of old people without their means of transportation.
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Lilli917
a little peace and quiet please.
11:10 PM on 09/22/2010
It's not always the doctors or hospitals, it's an organized fraud that bills millions of dollars a day on a regular basis. I have reported cases that patients have called about and they were investigated and litigated.