Senate finance members hint at changes to Medicare, Medicaid

WASHINGTON, D.C., April 26, 2013—While everyone agrees that preventing waste, fraud and abuse in Medicare and Medicaid is a top priority, questions abound about how to achieve that goal. How should the federal government preserve integrity in health care programs as well as a healthy marketplace and access to quality care at the same time?

Last year, the Senate Finance Committee invited stakeholders to submit white papers with recommendations about how to improve program integrity in Medicare and Medicaid.  A bipartisan report released this week by five members of the Finance Committee summarized concerns raised by the healthcare industry, patient advocates and other stakeholder groups about how to improve efforts to prevent waste, fraud and abuse. The key recommendations that emerged from the 146 stakeholder groups focused on improper payments, audit burdens, enforcement issues, data management and protecting beneficiaries.

The stakeholders included hospital and physician associations, insurers, durable medical equipment providers, and data management contractors. Read the full report titled, “Senate Finance Program Integrity White Papers: Summary and Overview of Recommendations.”

While this particular report merely summarizes varied concerns from different types of interested parties, an April 24 statement from the committee promises review of the recommendations to determine whether legislative action is needed.

Also, the Senate Finance Committee asked the Government Accountability Office to examine the federal auditing process for Medicare and Medicaid providers—or, audit the auditors. Kim Brandt, who is chief oversight counsel to Sen. Orrin Hatch, said earlier this week that the first of the GAO reports on audits is expected to be released within the next few months. Various health care provider groups including the American Association for Homecare and the National Association for Home Care and Hospice have proposed stronger anti-fraud and abuse measures.

This was reported by Michael Reinemer, principal of Reinemer Communications, a public affairs and marketing communications consulting firm based in Northern Virginia. Visit www.reinemercommunications.com.