KHN Morning Briefing

Summaries of health policy coverage from major news organizations

House Measure Introduced To ‘Eliminate Consumer Confusion’ About Who Is, And Is Not, A Doctor

The measure would make it illegal for health care professionals to make false or deceptive advertising claims. In addition, two Senate committees are focusing on various aspects of either fraud within the health care marketplace, or misleading sales tactics, as a means to find savings in Medicare and Medicaid. 

Medscape: New Bill Would Clarify Who Is A Medical Doctor And Who Isn't
Sponsors of a bill recently introduced in the House of Representatives aim to eliminate consumers' confusion over who is considered a medical doctor. Rep. Larry Bucshon, MD, (R-In.) and Rep. David Scott, (D-Ga.) are cosponsors of the bill, called the "Truth in Healthcare Marketing Act of 2013," (HR 1427), which was introduced on April 9 and referred to the Energy & Commerce committee. The bill would make it illegal for any healthcare professional to make false or deceptive claims in advertisements and marketing materials regarding their training, degree, license, or clinical expertise. Anyone marketing a health provider's services also must clearly state the license the provider holds (Frellick, 4/24).

St. Louis Beacon: McCaskill Grills Federal Officials, Bashes Firms On Medical Equipment Sales Tactics
A Chesterfield physician is deluged by faxes from companies claiming falsely that her patients had requested medical equipment. An elderly Missouri woman gets three or four calls a day from marketing firms trying to convince her to ask her doctor for equipment she doesn't need or want. … [Sen. Claire McCaskill at a hearing] alleged that misleading and possibly fradulent tactics by companies that sell durable medical equipment – such as diabetic testing and sleep apnea equipment – may be costing Medicare and Medicaid billions a year (Koenig, 4/24).

Modern Healthcare: Healthcare Industry Asks Feds For Clearer Guidance On Fraud, Fewer Audits
After sifting through 2,000 pages of public comments, staff members for the Senate Finance Committee say the healthcare industry wants clearer rules, fewer redundant audits and more focus on proactive healthcare fraud prevention. The committee was swamped with more than 150 reports from healthcare providers, insurers and suppliers last year after asking for suggestions on ways to prevent waste and improve fraud-fighting efforts in Medicare and Medicaid. About $65 billion was lost to improper payments from Medicare in 2011, according to one government estimate (Carlson, 4/24).

In related news -

Bloomberg: Medicare-Fraud Tip Rewards Boosted To $10 Million By U.S.
Tips that uncover Medicare fraud may be worth as much as $10 million for whistle-blowers, a boost from a maximum payout of $1,000, as the government seeks to reduce misuse of the health program. The action to raise the potential payments, modeled after an Internal Revenue Service program, may increase antifraud rewards to Medicare beneficiaries to 149 a year on average, compared with a total of 18 from 2000 to 2012, the Department of Health and Human Services said today in a statement (Wayne, 4/24).

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