Transparency Designed to Deter Health Fraud

Health care fraud is so profitable that organized crime is now in on it.  Billions of tax dollars go out in fraud every year, and law enforcement is waging an uphill battle against it. 

I know from beefing up the federal False Claims Act in 1986 that we constantly have to try new things to fight fraud.  Giving whistleblowers a financial incentive to come forward with information has become one of the most effective tools against fraud.   Since 1986, the law has recovered more than $28 billion and deterred billions of dollars in additional fraud against the taxpayers. 

In that spirit, this week I introduced legislation that includes new means to fight Medicare and Medicaid fraud.

One of my proposals would allow the public to see for the first time what individual physicians bill and receive from Medicare.  Providing transparency to this Medicare data would allow sunshine into this key part of the $500 billion Medicare program.  The bad actors would have less room to hide their crimes. 

The Wall Street Journal proved just how effective public disclosure can be in exposing fraud.  The newspaper and the nonprofit Center for Public Integrity sued the federal government to force the release of a limited amount of Medicare billing data.   From the limited information alone, the paper identified several medical practitioners who appeared to be cheating Medicare.  A physical therapist identified through this effort was indicted last month on charges of stealing from Medicare.

I believe the vast majority of doctors have integrity and don’t steal.  The public disclosure wouldn’t cause work or hardship for them.  Scores of federal contracts recently became public through a new website, USAspending.gov.  The idea behind that program is, with transparency comes accountability. 

That concept makes sense for Medicare payments.  A taxpayer dollar spent on Medicare isn’t any different on the public’s right to know than a taxpayer dollar spent on defense programs or on federal farm program payments to a farmer like me.  You can search my name online and see how much I’ve received in farm payments.   It’s public business. 

With the aging population and the national debt soaring, Medicare doesn’t have a dime to spare for cheats and thieves.  Transparency of Medicare payments, along with the other tools in my legislation, would help make potential criminals think twice before committing fraud.