This report originally appeared in the January 2010 issue of DOTmed Business News.
Senator Chuck Grassley (R-IA) has recently introduced legislation to address Medicare payment fraud through giving the federal government more time to reimburse Medicare providers if waste, fraud or abuse is suspected.
Grassley says that current federal law requires that Medicare reimburse providers within a very short timeframe, even if risk of fraud, waste or abuse is suspected. "Because of this prompt payment rule, the government puts itself in a position of having to pay and chase Medicare fraud, instead of working to prevent it in the first place. That doesn't make any sense," Grassley said in a press release, "and it's no way to manage Medicare's resources."
Under S. 2774, the Fighting Medicare Payment Fraud Act of 2009, if there is a determination that fraud, waste, or abuse involving a particular category of providers of services or suppliers, or providers in a certain geographic area, then the number of calendar days for reimbursement would be extended up to 365 calendar days for such time that is necessary to ensure that the claims are legitimate. Heightened scrutiny of claims would be instituted during this period. The bill would also prohibit administrative or judicial review of the extended reimbursement schedule.
