KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Arrests Made In Major Medicare Fraud Case

But CQ HealthBeat reports that the administration's top Medicare and Medicaid fraud buster told a Senate panel that the current-year spending plan being advanced by House Republicans could undermine the fed's efforts to reduce waste, fraud and abuse in the health care system.

The Miami Herald: Feds Make More Arrests In Major Medicare Fraud Case
A trio of doctors altered the diagnoses and medications of thousands of patients to make it look like they qualified for purported group therapy sessions at American Therapeutic's chain of South Florida clinics, costing the taxpayer-funded Medicare program hundreds of millions of dollars, prosecutors say. The doctors - Mark Willner, Alan Gumer and Alberto Ayala - were charged along with 17 others Tuesday in the nation's largest mental health care racket, according to the Justice Department. The charges were the latest in the widening criminal case against Miami-based American Therapeutic, which prosecutors say exploited patients - some suffering dementia and Alzheimer's disease - who could not possibly benefit from the treatments (Weaver, 2/15).

The Wall Street Journal: U.S. Charges 20 With Medicare Fraud
The federal government on Tuesday charged 20 people on counts of health care fraud, kickbacks and money laundering involving $200 million in unnecessary or fictitious mental-health treatments that were billed to Medicare. The multiagency Medicare Fraud Strike Force has indicted more than 850 people for allegedly illegal Medicare billings since its inception in 2007, according to the Justice Department and Department of Health and Human Services (Fitzgerald, 2/15).

CQ HealthBeat: Medicare Fraud Fight Would Be Harmed by House GOP Cuts, CMS Says
Medicare and Medicaid's top fraud buster told a Senate panel on Tuesday that cuts in current year spending proposed by House Republicans would imperil the government's ability to reduce fraud, waste and abuse in the public health programs. Peter Budetti, director of the Center for Program Integrity at the Centers for Medicare and Medicaid Services, said that a spending reduction would be a "major impediment" for the agency. New initiatives could not be started and planned enhancements to data systems could not go forward, he said (Norman, 2/15). 

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