Date: March 4, 2010

Time:  10:00 AM Eastern

Location:  Washington, DC

CHT Vice President Jim Frogue testified today on the topic of healthcare fraud to the House Committee on the Judiciary, Subcommittee on Crime, Terrorism and Homeland Security. Frogue began his testimony by outlining how pervasive of a problem healthcare fraud is in the United States – a problem that easily reaches hundreds of billions of dollars each year. He presented members of the committee with several solutions to combat fraud, including:

• Model the credit card industry by validating claims prior to paying for Medicare or Medicaid services. In addition, screen out bad vendors before they even have the ability to file a claim, only to be chased after later.
• Allow for better data sharing across departmental jurisdictions and with state and local governments.
• Consider posting all claims online for public access as a way to better identify outlier billing. Payment and patient data would be de-identified to respect privacy issues.
• Open up claims data to audits conducted by contingency-fee based companies.
• Use private sector standards for establishing the number of suppliers for a product or service in a defined area.
• Add the phrase, “under penalty of perjury” to CMS form 855 to assist prosecutors going after crooks.
• Authorize demonstration projects whereby the authentication of new suppliers is outsourced by and to an entity not CMS.

Other witnesses included Greg Andres (U.S. Department of Justice), Timothy Menke (U.S. Department of Health and Human Services) and D. Mark Collins (Director of Nebraska Medicaid Fraud Control Unit).