KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Federal Program Cracks Down On Medicare Fraud In Houston

A federal program targets Medicare fraud in the Houston area as news of three cases representing at least $35 million in false claims emerged within the past week. The Houston Chronicle reports on the three cases, noting: "These Houston-area scams alleged in two FBI complaints and one Montgomery County indictment were among six reported nationally in a single week - representing at least $285 million in false billings, records showed. 'This is an astounding amount,' said Houston's FBI spokeswoman Pat Villafranca. The $285 million is more than four times the amount stolen during robberies of U.S. banks during all of 2008, she said. This month, Houston became the fourth metropolitan area - joining Miami, Los Angeles and Detroit - to create a ramped-up fraud strike force. It goes by the acronym "HEAT," Health Care Fraud Prevention and Enforcement Action Team."

The Chronicle reports: "Using cutting-edge technology, the strike force can identify Medicare irregularities at unprecedented speeds, completing in days what used to take months. The strike force harnesses resources from the Justice Department, U.S. Health and Human Services and law enforcement. ... While politicians argue over health care reform, U.S. Sen. John Cornyn, R-Texas, said the estimated $60 billion loss in Medicare fraud each year must be addressed first. He said these losses could speed the collapse of the Medicare fund, which is projected to be insolvent in eight years. He has introduced a bill that calls for a 'real-time surveillance program' to monitor claims" (Horswell, 7/12).

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