HHS Reports On Medicare Fraud Reduction Efforts

Ruzanna Harutyunyan's picture

Two newspapers recently published editorials that addressed an HHS Office of Inspector General draft report on Medicare fraud reduction. According to the report, CMS in 2006 based claims of a $700 million reduction in Medicare durable medical equipment fraud on improper auditing conducted by an outside contractor. The report claims that CMS officials told AdvanceMed, the contractor, to ignore an auditing program -- called Comprehensive Error Rate Testing, or CERT -- which is required by law (Kaiser Daily Health Policy Report, 8/21). Summaries of the editorials appear below.


* Kansas City Star: "With the administration predicting a record $482 billion deficit for next year, President Bush and Congress should be vigorously pursuing waste and corruption wherever they are likely to be found," and that "certainly includes Medicare," a Star editorial states. According to the editorial, "Medicare officials claim they have been tightening things up," but the "alarming report ... raises serious doubts about that." The editorial states, "Simply assuming honesty on the part of the sellers of this equipment is an obvious invitation to further fraud," and Congress and the Department of Justice "need to start asking Medicare officials some hard questions about their operations -- and their odd notions of auditing." The editorial concludes, "The country is way too far in debt to keep throwing money at crooks" (Kansas City Star, 8/21).

* New York Times: Medicare "faces a daunting array of financial problems," and the "public's trust in the program has been repeatedly tested by reports of waste and fraud," according to a Times editorial. The "claims of success -- and savings" -- for which Medicare officials received "high praise" in 2006 are "crumbling" as a result of the report, the editorial states, adding, "Congressional committees will need to sort out how much of this problem is sloppy documentation and how much reflects payment for medical services that should never have been provided and often weren't." In addition, "Congress must also recognize its own failure to give Medicare an important tool to combat fraud and waste" -- the postponement of a "new competitive bidding program for durable medical equipment that would require a more intense look at the qualifications and integrity of the suppliers," the editorial states. The editorial concludes, "With Medicare expenditures soaring, there is no room for any more waste, fraud or complacency" (New York Times, 8/22).

Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2007 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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