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Yesterday the Senate Finance Committee posted an open letter on its website to the health care
sector soliciting industry stakeholder insights on ways to combat
fraud, waste, and abuse in the Medicare and Medicaid programs. This
letter comes on the heels of an April 25th
hearing at which the members questioned government officials
from the Department
of Health and Human Services' Office of the Inspector
General (HHS-OIG), the Centers for Medicare & Medicaid Services,
and the Government
Accountability Office about the effectiveness of fraud-fighting
efforts. The open letter now invites a broader audience, including
the private sector, to opine on the best ways to prevent and detect
unlawful conduct and waste involving government health care
programs.
The Committee is requesting actors in the health care sector to
submit "white papers" in PDF or Microsoft Word format
that address potential improvements in the following
categories:
Program Integrity Reforms to Protect Beneficiaries and Prevent
Fraud and Abuse
Payment Integrity Reforms to Ensure Accuracy, Efficiency and
Value
Fraud and Abuse Enforcement Reforms to Ensure Tougher Penalties
Against Those Who Commit Fraud
The white papers should be submitted via email by June 29th to
ProgramIntegrityWhitePapers@finance.senate.gov.
The Committee members plan to have their staff review the white
papers and then compile a summary document highlighting key
proposals later in 2012.
This letter is the most recent instance where the government has
sought the expertise of the private sector in addressing fraud,
waste, and abuse. Another example came to light in February 2012,
when HHS-OIG issued its report related to the Pharmacy Compliance
Roundtable, where it convened compliance professionals in the
pharmaceutical industry. There, the private sector players
discussed their experiences with Corporate Integrity Agreements
(CIAs) and other compliance efforts initiated by the government
with HHS-OIG representatives. Prevention is becoming the new focus
of fraud-fighting efforts, and the government needs private sector
cooperation to achieve its goals in this area.
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