Fo­cus on pre­vent­ing fraud over fines and penal­ties

Modern Healthcare - - COMMENT -

Re­gard­ing “Bud­get deal raises stakes for false claims, civil mon­e­tary penal­ties” (Mod­ern­Health­, Nov. 9), while leg­is­la­tion in­creas­ing fines to as­tro­nom­i­cal lev­els gets at­ten­tion (and may be un­con­sti­tu­tional, as the ar­ti­cle pointed out), it’s not a re­al­is­tic de­ter­rent. Ef­forts would be bet­ter spent on fraud preven­tion rather than fine rev­enue. It’s gen­er­ally ac­cepted that 30% of health­care costs is fraud, waste and abuse and yet Medi­care/Med­i­caid re­cov­er­ies are a frac­tion of 1%. I be­lieve eas­ily doc­u­mented fraud and abuse in the Med­i­caid sec­tor is in the range of 13% to 16%. Once again, our leg­is­la­tors go for the sen­sa­tion­al­ism in­stead of ef­fec­tive re­sults. Michael Cadger

CEO Mon­o­cle Health Data


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