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Date: Saturday, January 24, 1998
WHITE HOUSE FACT SHEET
Contact: HHS Press Office (202) 690-6343
PRESIDENT CLINTON ANNOUNCES UNPRECEDENTED PROGRESS IN FIGHTING MEDICARE FRAUD AND ABUSE
Today, President Clinton announced the first annual progress report by the Departments of Justice and Health and Human Services on the nation's successful efforts in cracking down on Medicare fraud and abuse. He also unveiled a series of new legislative and executive actions to build on the administration's impressive record in this area, specifically, he announced:
- That Nearly $1 Billion Has Been Returned to the Medicare Trust Fund in Just One Year
- A 10-Step Anti-Fraud and Abuse Legislative Package That Saves Medicare at Least $2 Billion
- Unprecedented Steps to Involve Medicare Beneficiaries in Identifying and Combating Fraud and Abuse
- Nationwide On-Site Inspections to Target Medical Supplier Rip-Off Artists
- A Nationwide Conference, With Law Enforcement Officials and Others, Designed to Identify the Next Steps to Fight Fraud and Waste
THE PRESIDENT ANNOUNCED:
A Justice/HHS Report Which Cites Nearly $1 Billion in One Year in Savings For the Medicare Trust Fund. On Monday, the President is sending to Congress the first annual report of the Health Care Fraud and Abuse Control Program -- created by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) -- which shows remarkable progress in rooting out health care fraud and abuse. In FY1997 alone, the first full year of anti-fraud and abuse funding under HIPAA, nearly $1 billion was returned to the Medicare Trust Fund, the largest amount ever. These efforts:
- Returned nearly $1 billion to the Medicare Trust Fund from collections of criminal fines, civil judgements and settlements, and administrative actions. This was the largest recovery amount ever collected in one year.
- Excluded more than 2,700 individuals and entities from doing business with Medicare, Medicaid, and other federal and state health care programs for engaging in fraud or other professional misconduct -- a near doubling (a 93 percent increase) over 1996.
- Increased convictions for health care fraud-related crimes by nearly 20 percent.
- Pursued 4,010 civil health care fraud cases -- an increase of 61 percent over 1996.
A New 10-Step Anti-Fraud and Abuse Legislative Package That Saves Medicare At Least $2 Billion Over Five Years, including the following:
- Eliminating overpayments for certain drugs, for which the Inspector General has reported Medicare currently overpays.
- Ensuring Medicare does not pay for claims that ought to be paid by private insurers, such as taking steps to ensure that Medicare is aware of liability settlements and of other coverage obligations of private insurers. Asking providers to pay for their audits, which will allow Medicare to double the number of audits.
- Ensuring that providers do not leave Medicare strapped by declaring bankruptcy.
Unprecedented Steps to Involve Medicare Beneficiaries in Identifying and Combating Fraud and Abuse. The President is announcing steps to involve Medicare beneficiaries in rooting out fraud and abuse, such as:
- Providing beneficiaries with new information on how to report fraud. Starting next month, Medicare beneficiaries across the nation will receive a toll-free number to call to report fraud and abuse in Medicare on every statement, bill, and claim, making it easier to crack down on fraud and abuse; and
- Rewarding beneficiaries for fighting fraud. Provisions in the Kassebaum-Kennedy legislation will be implemented this spring that give beneficiaries rewards for reporting fraud.
On-Site Inspections Across the Country to Eliminate Rip-Off Artists and Scam Medical Equipment Suppliers. To ensure that medical equipment suppliers are providing the medical devices they claim, the Department of Health and Human Services is conducting nationwide on-site inspections of medical suppliers.
A National Conference to Bring Together Law Enforcement, Providers, Beneficiaries, and Others to Identify the Next Steps to Fight Fraud and Waste. While the Administration has a long record of fighting fraud and abuse, we must do more. Today, the President is announcing that this spring, the Health Care Financing Administration will hold a conference including consumers and their representatives, law enforcement officials, private insurers, health care providers, and beneficiaries, to build on the successes we have achieved in fighting fraud and abuse in the nation's health care system.