GOP puts heat on Obama's 'costly' Medicare fraud-fighting technology

By Diana Manos
10:41 AM

 Sen. Charles Grassley (R-Iowa), ranking member of the Senate Finance Committee, is pressuring President Barack Obama's administration to defend how it has spent money fighting Medicare fraud, including the addition of new fraud-fighting IT.

"Medicare fraud data doesn't support rhetoric or spending to crack down on criminal healthcare fraud," Grassley said last week in a letter to Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius.

Grassley expressed concern about what he called "the stagnating number of criminal prosecutions" for healthcare fraud despite increased federal spending to fight fraud.

"I want to know why the Justice Department is having a tougher time putting people behind bars when we're giving them millions more to do the job," he said.

The Obama administration defends this year as one of the best for beating Medicare fraud. In October, Department of Justice officials had what they called the largest Medicare fraud bust ever, with 73 people indicted and charged with a variety of healthcare fraud-related crimes that involve more than $163 million in fraudulent billing.

The Centers for Medicare and Medicaid Services is optimistic that new fraud fighting analytic tools announced this month will prevent wasteful and fraudulent payments to Medicare, Medicaid and the Children's Health Insurance Program.

Federal officials said the tools would integrate many of the agency's pilot programs into the National Fraud Prevention Program and complement the work of the joint HHS and Department of Justice Health Care Fraud Prevention and Enforcement Action Team (HEAT).

"This has been a remarkable year for cracking down on healthcare fraud - and our success has been built on initiatives like these combining the experience and insight of our law enforcement teams with new resources and cutting-edge technology," Sebelius said. "Thanks to the new tools and resources provided under the Affordable Care Act, we are more effective at going after the fraudsters that are stealing taxpayer dollars."

Holder said, " Simply put, we have taken our fight against healthcare fraud to a new level, and I am committed to continued collaboration, vigilance and progress."

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