White House Wants to Stop Medicare, Medicaid Billing Errors and Fraud

Federal government to use payment recapture audits to fight Medicare, Medicaid fraud.  President Barack Obama is expanding payment recapture audits as a means of fighting waste and abuse in government programs such as Medicare and Medicaid.  The presidential memorandum will direct federal agencies to “expand and intensify” the use of audits, such as those performed by recovery audit contractors and Medicaid integrity contractors.  The initiative will extend the scope of such audits beyond fee-for-service payments into other government contracts.  The president also will support bipartisan legislation to expand the authority of government agencies to direct recaptured funds toward audits.

The announcement follows an executive order issued by President Obama in November, 2009, that directed the government to aggressively control improper payments, which were said to equal $98 billion.  Fully $54 billion of that was attributed to Medicare and Medicaid and reflect an estimate of payments made in error, duplicate billing and even fraud.

Aimed at the political middle and designed to rally support for healthcare reform, the proposal would employ private auditors whose sophisticated computer systems can scan Medicare and Medicaid billing records for patterns of false claims.  The auditors would get to keep some of the dollars recovered.  According to the White House, a Medicare pilot program recovered approximately $900 million for taxpayer between 2005 and 2008.

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