The National ACO Association, a medical group that helped identify the fraud charges, told its members in February that at least $2.8 billion in Medicare claims last year alone were related to catheters, citing a review of federal claims data. I warned you. This represents an increase of approximately 30% from the group’s previous estimates.
The association said the claim included data on more than 400,000 patients. The doctors and patients whose identities were used to bill Medicare said they had never ordered or received the catheter, saying there had been no change in medical practice and the device was not causing a spike in bills. Ta.
The House Energy and Commerce Oversight Committee, Chairman Ways, and Chairman of the House Energy and Commerce Oversight Committee, said, “As the committees responsible for oversight of Medicare, and as the chairs of the Republican Physicians Association, I cannot accept such blatant fraud.” “We are concerned that the conduct may have gone undetected for over a year.”The Ways and Means Committee and other Republican leaders sent a letter to federal health officials In a letter shared with the Post. “If so, failure to detect such fraud would threaten Medicare’s financial health, undermine public trust, and jeopardize the well-being of its beneficiaries.”
Rep. Cathy McMorris Rodgers (R-Wash.), chairwoman of the House Energy and Commerce Committee, and other Republican leaders are calling on the Department of Health and Human Services’ inspector general and the Centers for Medicare and Medicaid Services to first We asked him to explain when he discovered the virus. The allegations included fraud, whether insurance payments were paid or portions of them were placed in escrow, and how companies were able to obtain confidential patient data to submit catheter bills. . Republican leaders also asked for briefings from the Health Department’s inspector general and CMS within the next two weeks.
The Post reported in February that the FBI and others were investigating him for possible fraud.
The FBI Public Affairs Office said Wednesday that it could not confirm or deny the existence of an investigation, citing the agency’s standard practices. Officials from CMS and the HHS Office of Inspector General said they could not discuss the allegations, specific suppliers or the existence of a federal investigation.
Health Department Secretary Xavier Becerra acknowledged the existence of a federal review in an interview with the Post.
“There is an active investigation underway,” Becerra said last month. “I really can’t say more than that.”
The Office of the Inspector General of Health and Human Services is Consumer warning Wednesday warned of fraudulent schemes involving urinary catheters and provided recommendations on how seniors can protect themselves.
“Scammers target Medicare enrollees through phone calls, internet ads, and text messages, verify personal information and eligibility for certain Medicare services, and then offer offers of free services, medical equipment, or gift cards. “There are,” the agency’s warning reads. “Once the scammers have the enrollee’s personal information, they begin billing Medicare monthly for medically unnecessary urinary catheters that may or may not actually be sent to the enrollee.”
Christian Schrank, deputy inspector general for investigations at the Department of Health, said fraudulent claims for durable medical equipment are the latest challenge faced by the Department of Health, which has been investigating fraud schemes related to blood sugar monitors, coronavirus tests and other equipment. He reiterated that this is a long-standing problem.
In a statement to the Post, Schrank said the Office of Inspector General “remains committed to protecting the public from fraudulent schemes.”
CMS also reiterated that it is using several tools to prevent fraudulent claim payments, including stopping some businesses from receiving payments. “This means that even if a claim is publicly shown to have been paid, that money will not be released,” the agency said.
Representatives and senators from both parties have expressed alarm over allegations of fraud surrounding urinary catheters. They said older Americans are particularly vulnerable to schemes that prey on their lack of experience with technology or use deceptive tactics to collect personal information.
“Medicare is a lifeline for millions of older Americans, and we are committed to supporting the program and its beneficiaries,” Sen. Bob Casey (D-Pa.), chairman of the Senate Select Committee on Aging, said in a statement. “A targeted fraudulent scheme is unacceptable.” . “We must ensure that federal authorities have the resources necessary to police these programs and protect seniors from exploitation.”
Lawmakers noted that the problem of Medicare fraud goes beyond the administration, with tens of billions of dollars connected to fraud schemes each year.
“I’m not going to blame this on politics. I’m going to blame this on bureaucracy,” said Rep. Greg Murphy, RN.C., a urologist. His office was instrumental in conveying constituent concerns about catheter fraud to the Justice Department. “We need some answers. … This is nearly $3 billion of taxpayer money.”
Several members of Congress touted legislation to strengthen Medicare’s anti-fraud efforts. law Sens. Bill Cassidy (R-LA) and Mike Braun (R-IN) introduced a method to use data analytics to identify irregular billing patterns. But Cassidy and others said the scale of the alleged catheter fraud suggests he should have been arrested sooner.
Cassidy, the top Republican on the Senate Health, Education, Labor and Pensions Committee, said in a statement: “We shouldn’t need artificial intelligence to suddenly see $2 billion more urinary catheters being shipped to Medicare patients.” mentioned in. post. “CMS needs to be better. Much better.”
Dan Keating and Lauren Weber contributed to this report.
