Congressman Takes Swipe at Program to Reduce Medicare Fraud (Center for Public Integrity)

[pinto]

Congressman Takes Swipe at Program to Reduce Medicare Fraud
Bill To Scrap Competitive Bids Attracts 70 Cosponsors

By Naseem Miller and Joe Eaton | November 19, 2009

http://www.publicintegrity.org/articles/entry/1823/

As health reform bills consume Congress, a battle over a program designed to help cut soaring rates of Medicare overpayment and fraud is playing out unnoticed on the sidelines.

The dispute concerns so-called durable medical equipment — items like power wheelchairs and oxygen supplies. Federal investigators have long complained that the equipment business was a hotbed of Medicare abuse. A competitive bidding program for durable medical equipment finally went into effect late last month after an 18-month delay that was mandated by Congress. But a bill introduced by Florida Democrat Kendrick Meek that would scrap the competitive bidding program for good has picked up 70 cosponsors since it was introduced five weeks ago.

The squabble is occurring just as the Department of Health and Human Services is reporting — according to the Associated Press — that the federal government paid more than $47 billion in questionable Medicare claims in fiscal year 2009, and just as President Obama prepares to sign an executive order cracking down on improper payments by a variety of federal programs, Medicare prominently among them.

The roots of the fight over durable medical equipment go back to 2003, when Congress authorized the Competitive Bidding Program as part of the Medicare Modernization Act. The bidding program required medical equipment suppliers to bid for Medicare contracts, overturning a system under which suppliers would automatically be paid under an established system of fees. Medicare officials expected competitive bidding would drive down prices and weed out fraudulent suppliers in an industry long plagued by shady storefront businesses, corrupt medical professionals, and organized crime.

The Government Accountability Office has concluded in numerous reports going back more than a decade that Medicare pays far higher than market rates for medical equipment. The federal Centers for Medicare & Medicaid Services estimated that Medicare improperly paid $1 billion for durable medical equipment from April 2006 to March 2007, in part due to fraud, according to a 2008 GAO report.

“Across the board, durable medical equipment has been an area where fraudsters have loved to prey for a long time,” said Gerry Roy, the assistant inspector general for investigations at Health and Human Services’ Office of Inspector General. Roy said organized criminal groups set up fake storefronts for 60 days and move on after bilking Medicare for hundreds of thousands of dollars in fraudulent claims for products including wheelchairs, oxygen, and prosthetics.

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http://www.publicintegrity.org/articles/entry/1823/

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[michael reinemer]

1. This is character assassination

This article suggests that the "competitive" bidding program for durable medical equipment is an anti-fraud program (it is NOT), and that by opposing the bidding program that Meek is somehow soft on fraud. This is a disgraceful lie. The Center for Public "Integrity" ought to have enough integrity to at least rewrite this incredibly dishonest headline. DU does no one any favors by perpetuating the distortion. Anyone who wants the straight story can contact me directly at [e-mail]. I work for the durable medical equipment sector and we have endorsed by toughest anti-fraud bill in Congress to date, a bill introduced by Sen. George LeMieux last month.