Senators Press CMS on Efforts Against Provider Fraud

http://www.medpagetoday.com/PublicHealthPolicy/Medicare/52782?xid=nl_mpt_DHE_2015-07-25&eun=g875301d0r 

Sen. Elizabeth Warren (D-Mass.) pressed Agrawal on another topic: providers who stayed in the program despite repeated transgressions. “Instead of kicking big-time bad actors out of Medicare, the government settles with a fine and the company enters into a corporate integrity agreement,” she said.

Warren cited the case of Tenet Health, a $5.8 billion corporation with 81 hospitals and several hundred outpatient centers. “In 1994, [Tenet] paid a $379 million fine for illegal kickbacks to doctors, and signed a corporate integrity agreement. Then in 2006, Tenet got caught fraudulently billing Medicare and paying illegal kickbacks to doctors, and paid a $900 million fine.”

“In 2012, Tenet admitted breaking the law again, and paid a $42 million fine. Just a year later, they got a $4 million slap on wrist for misconduct,” she continued. “So if a big company can commit major fraud and be fined and promise to be good, and move on, I’m not sure there’s an incentive not to break the law. When is it that you say, ‘Enough is enough’?”

Agrawal responded that settlements are not handled by his office but by the Justice Department and the Health and Human Services Office of Inspector General (OIG)…

6 thoughts on “Senators Press CMS on Efforts Against Provider Fraud

  1. Our regulatory agencies that are in charge of protecting the interest of the people are corrupt. Senator Warren is in the position to challenge this because the people of masseuses voted her into office.

    The 99 percent in the rest of the nation should take a lesson. Not voting is an ineffective way to protest a corrupt system when voting is the only way to change it.

    Liked by 1 person

    • Voting isn’t the only way to change a corrupt system. You have to educate, too. And that can take time, even in the internet age. Maybe sometime in the future, everyone will have access to easy, electronic voting, and things will begin to change. (Followed by corruption and hacking of the system.)

      Liked by 1 person

        • Ignorance is just a choice some people make because they’re unable to deal with their fear — whatever it may be. I have a fear of flying, but I prefer to be ignorant of how planes actually work. Even if I understood the science of it, I would still wonder how a craft that heavy can fly. It’s the visuals of seeing those huge crates of metal soaring in the sky, especially next to tiny little birds.

          Ignorance can be a type of protective measure for the brain, sometimes needed by people who crave stability and hate change. But neuroplasticity offers hope — we all have the ability to change. So your faith is not misplaced. 🙂

          Like

If you don't comment, I'll just assume you agree with me

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s