Straying from the “pay and chase” approach to fraud, healthcare programs are concentrating on preventing “bad actors” from fraudulently billing Medicare or Medicaid, according to a Reuters report.
Peter Budetti of the Centers for Medicare and Medicaid Services said fraudsters are “becoming more sophisticated and the schemes more difficult to detect,” according to the report. Historically, Medicare and Medicaid would pay claims and then chase after those discovered to be fraudulent. CMS is now trying to prevent individuals and companies that intent to defraud federal programs out of them in the first place, according to the report.
Along with preventing these bad actors from participation in federal programs, Mr. Budetti said CMS wants to remove such individuals if they are approved for participation.
Read the Reuters report on healthcare fraud.
Read more about Medicaid and Medicare fraud:
– Tennessee Anesthesiologist Dr. Allen Foster Pleads Guilty to Overbilling Medicare
– Maryland Internist Allegedly Bilked More Than $800K From Medicare, Medicaid
– New York’s APS Healthcare Pays $13M to Settle False Claim Allegations
