The Affordable Care Act combats fraud and abuse By Steve Benen

http://www.washingtonmonthly.com/political-animal/2012_01/the_aca_actually_combats_fraud034488.php

January 03, 2012 10:45 AM
By Steve Benen

John McDonough has a good piece on an overlooked benefit from the Affordable Care Act: it’s doing quite well in combating fraud and abuse, which in turns saves Americans quite a bit of money. (via TOA)

Members of Congress of both parties often complain about fraud and abuse in Medicare and Medicaid (M&M), usually charging that the President is not doing enough to keep bad guys from stealing money from these vital programs.

Guess what? Thanks to provisions in the Affordable Care Act (ACA/ObamaCare) and to an unprecedented effort by the Obama Administration, more progress has been made in the past three years to combat health care fraud and abuse than ever before. There was a 68.9 percent increase in criminal health care fraud prosecutions from 2010 to 2011, and 2010 was already the highest ever.


McDonough helped work on the ACA’s provisions related to fraud prevention, and sketches out the areas in which the law is improving enforcement.

Part of the effort involves hyper-charged efforts to catch bad guys through the Health Care Fraud Prevention and Enforcement Action Team (HEAT), and a bigger part involves re-engineering the system to keep them out. For example, prior to the ACA, if a bad guy got kicked out of one state Medicaid program for fraud, he got kicked out of one program; under the ACA, when he gets kicked out of one, and he gets kicked out of all them, including Medicare. That’s smart, and that’s just a tiny bit of what the ACA does on fraud & abuse.


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