KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Short On Funds, HHS Failed To Investigate 1,200 Fraud Cases Last Year

HHS was unable to investigate 1,200 cases of suspected Medicare or Medicaid fraud last year because the watchdog agency inside the department is stretched so thin.

Fiscal Times: 1,200 Medicare Fraud And Abuse Cases Went Unchecked In 2012
The watchdog agency for the behemoth Department of Health and Human Services is stretched so thin that it was unable to investigate at least 1,200 cases of Medicare and Medicaid fraud and abuse last year, leaving the agency vulnerable to losing out on millions of dollars, Gary Cantrell, deputy inspector general for Health and Human Services said at a congressional hearing last week. Cantrell's announcement comes just as the auditing agency prepares to cut 400 workers nationwide from its 1,800-person workforce. Cantrell warned that with continued budget cuts and a huge reduction in staff, the agency will likely fail to investigate even more cases in the coming year (Ehley, 7/2).

In related news -

The Associated Press/Washington Post: Justice Department, 55 Hospitals Reach $34 Million Settlement Over Medicare Fraud Claims
Fifty-five hospitals in 21 states have agreed to pay $34 million to the U.S. government to settle allegations that they used more expensive inpatient procedures rather than outpatient spinal surgeries to get bigger payments from Medicare, the U.S. Justice Department said Tuesday (7/2).

Georgia Health News: 5 Hospitals Join Settlement On Overcharging
Five hospitals in Georgia are among 55 facilities in 21 states settling allegations of overcharging Medicare for a back procedure. The overall $34 million settlement, announced Tuesday, involved a false claims case involving kyphoplasty, a procedure for treating spinal fractures that are frequently caused by osteoporosis (Miller, 7/2).

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