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Medicare Providers And Suppliers Draw Increased Scrutiny

The past two years have seen a tremendous surge in the number of providers and suppliers who have been banned from billing Medicare for services rendered. The number coincides with a sharp increase in the legal actions taken against doctors and medical suppliers in cases of Medicare fraud. According to the Department of Health and Human Services, revocations in the last two years were approximately 250 percent higher than the two-year period that preceded it. That number is nationwide. In some areas, revocations are up nearly 400 percent.

One government official suggested that the Affordable Care Act has spurred action in protecting the integrity of the Medicare program. More plans are on the way to identify improper Medicare billing. A program that once paid up to $10,000 to Medicare beneficiaries who provide tips to catch fraudulent billing may soon allow for rewards of up to $9.9 million. With nearly 50 million Americans currently qualified to receive Medicare benefits, the program has the potential to greatly increase the number of tips provided to government officials.

The Medicare hotline used to gather tips from beneficiaries gathered more than 40,000 calls that were used in fraud investigations last year. Many of these tips involved Medicare beneficiaries who had their numbers used by doctors they did not remember seeing. The government hopes that greatly increasing the incentive to report improper use of a Medicare beneficiary number they will be able to reduce fraud in the program.

Source: USA Today, "Policing of Medicare fraud explodes over two years," by Kelly Kennedy, 5 June 2013

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