Health

Published — June 22, 2011 Updated — May 19, 2014 at 12:19 pm ET

IMPACT: Bipartisan bill targets Medicare scammers

Introduction

Two senators introduced bipartisan legislation Wednesday that aims to crack down on fraud in federal health programs for the poor and the elderly.

The Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayer Dollars Act, introduced by Sens. Tom Carper, D-Del., and Tom Coburn, R-Okla., includes a provision that would require all prescriptions paid for by the Medicare Part D prescription drug plan include a valid physician identifier. That is currently not required.

In February, iWatch News reported that the use of invalid physician prescriber numbers is so common that the program cannot identify the top physician prescribers of oxycodone and Ritalin, two highly addictive drugs frequently trafficked on the street. The story also reported that some Medicare scammers have stolen the identities of dead physicians to bill Medicare for drugs under the plan.

In addition to requiring valid prescriber numbers, the Carper and Coburn bill would restrict access to the National Provider Registry, a list of physicians and their provider identification numbers that is currently open to the public online. The American Medical Association has long pushed for restricting access to the registry to combat fraud and prevent Internet surfers from stealing physician identities.

The bill includes a number of other anti-fraud provisions, including one that would phase out the so-called “pay and chase” Medicare policy, in which the government checks claims for fraud only after the claim is paid, which often allows fraudsters to stay one step ahead. Instead, the bill would require the Centers for Medicare and Medicaid Services to perform prepayment checks before paying providers.

“As Congress faces unsustainable debt and runaway entitlement programs, Americans want us to work together to strengthen the integrity of the Medicare and Medicaid system,” Coburn said in a news release Wednesday.

The Senate bill is co-sponsored by four Republicans and two Democrats. Rep. Peter Roskam, R-Ill., is expected to introduce a companion bill in the House soon, according to the press release.

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