Feds Add More Resourses to Fight Healthcare Fraud

The Centers for Medicare & Medicaid Services Program Integrity Group at recently opened a field office in Santa Ana, California, aimed at preventing and prosecuting health care fraud.
“In the two years since the office has been up and running, we have been able to stop almost $2billion in inappropriate or improper payments from going out the door,” program director Kimberly Brandt said.
Like the Medicare Fraud Strike Force office in South Florida that arrested 38 people for defrauding the federal program out of more than $142million, the Santa Ana office uses “data mining” technology to target fraudulent Medicare and Medicaid billings.
According to Assistant U.S. Attorney Consuelo Woodhead, who coordinates federal health care fraud prosecutions in Los Angeles, officials could double the number of law enforcement personnel fighting the problem and still fall short of having enough people to make a significant difference.
Woodhead thinks, that “to really effectively deal with the problem, we’re going to have to take a multidisciplinary approach where you look at licensing and certification, how claims are processed, as well as strong criminal and civil enforcement after claims are paid.”

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