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Anti-fraud Efforts Net Record Returns

02/23/12

Permalink 05:09:21 pm, by MedBen5 Email , 210 words, 1072 views   English (US)
Categories: News, Health Plan Management

Anti-fraud Efforts Net Record Returns

The perpetrators of health care wrongdoing have undoubtedly been sleeping a lot less easy of late. In fiscal 2011 alone, the federal government recovered $4.1 billion in fraudulent health care payments – the largest amount ever collected in a single year, according to federal officials.

MedPage Today reports that between 2009 and 2011, enhanced efforts to combat fraud resulted in a 50% increase in judgments and settlements of payments fraudulently obtained from Medicare and Medicaid. Last year, criminal charges were filed against 1,430 defendants for fraud-related crimes, 743 of whom were convicted.

The Affordable Care Act has earmarked $350 million to fight health care fraud. Common cases include durable medical equipment fraud; illegal marketing of medical devices or drugs for uses not approved by the FDA, including unlawful pricing by drugmakers; and violations of self-referral and anti-kickback laws.

At MedBen, we share a similar dedication to protecting clients against fraud (with a slightly smaller budget, of course). Our Anti-Fraud Unit reviews questionable claims, and other related information, to help conserve plan assets. We also belong to associations formed to share information regarding possible fraudulent activities, and the data we obtain from them is compared against our claims detail daily.

For additional information on how MedBen’s anti-fraud efforts, contact Vice President of Sales and Marketing Brian Fargus at (888) 627-8683.

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