KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Dems Tout Savings From Medicare Fraud Crackdown, Swindlers Exploit Health Bill Confusion

The Hill: "Democrats on the Senate Finance Committee are trying to make the case that the healthcare bill will strengthen Medicare and Medicaid by finding major savings through a crack down on fraud, waste and abuse."

"The bill will require private insurers who provide health benefits to seniors as part of the Medicare Advantage program to spend at least 85 percent of revenue from premiums on healthcare instead of banking them as profits or using them to offset overhead costs, the [Senate] Finance Committee staff said in a memo. The payment rate for Medicare Advantage insurers will also be linked to local Medicare spending to try to reduce the $132 billion in overpayments they get, the staff said. To crack down on waste that costs more than $60 billion a year, the bill will increase funding for fraud and abuse programs by $350 million this decade, raise penalties for fraud and abuse and use new technologies to identify wrongdoing" (Alarkon, 4/1).

NPR reports on "swindlers hoping to take advantage of Americans confused by what the new health care law means for them." Already, "a cable television advertisement exhorted viewers to call an 800-number so they wouldn't miss a 'limited enrollment' period to obtain coverage available 'now that historic health care legislation has passed.' And there have already been reports of door-to-door salespeople peddling 'Obamacare' insurance policies. There is, of course, no limited enrollment period for any coverage, and no such thing as a new federal insurance policy named after the president."

"The Coalition Against Insurance Fraud has characterized the nation's current economic climate as having created a 'perfect storm of vulnerabilities' for consumers, from millions of uninsured Americans and stubborn unemployment, to the rising cost of health insurance premiums. Add to this the uncertainty over what the new health care law does and doesn't do" (Halloran, 4/1). This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.