CMS, VA to share data to prevent healthcare fraud
- CMS on Tuesday announced a partnership with the U.S. Department of Veterans Affairs (VA) to share data and best practices to identify and prevent healthcare fraud, waste and misuse.
- VA plans to use CMS analytics to improve fraud detection, prevention and close existing gaps in its own claims payment process.
- The partnership is the latest in federal agency step to increase healthcare fraud and misuse prevention efforts. Last summer, the Department of Justice (DOJ) created its Health Care Fraud Unit to focus on healthcare fraud prosecutions.
The government has been stepping up enforcement efforts to combat healthcare fraud and waste.
Last summer, HHS charged 412 individuals for a total of over $1.3 billion in false healthcare billings, its largest takedown to date. In 2016, the DOJ charged more than 300 medical professionals for about $900 million in alleged fraudulent billing.
Just last week, a Michigan physician was sentenced to 24 months in prison for his part in a $1.7 million healthcare fraud scheme involving billing Medicare for physician home visits that were medically unnecessary.
Since its creation in 2007, the Medicare Fraud Strike Force has charged more than 3,500 individuals with allegations of defrauding Medicare of over $12.5 billion.
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