Feds tap private companies for fraud/abuse help
HCFA contracts for outside services
Making good on a long-time goal, last month the Health Care Financing Administration selected 12 companies to compete for so-called Program Safeguard fraud and abuse prevention contracts as part of the agency’s new Medicare Integrity Program (MIP).
HCFA expects to award approximately $500 million in Medicare fraud prevention contract assignments over the next five years to the MIP Program Safeguard contracting pool, which includes information technology and accounting firms, as well as current Medicare contractors.
Participating companies will compete this summer for six Medicare fraud and abuse prevention contracts involving:
• development of a national education program for Medicare providers;
• on-site reviews of providers to verify their compliance with HCFA agreements;
• cost-report audits for large health care chains;
• prevention of potential Y2K computer problems;
• on-site reviews of community mental health centers;
• fraud and abuse detection activities in six New England states for Medicare Part A.
This new force of private fraud detectives is expected to use high technology and powerful statistical methods to drastically reduce the $12.6 billion a year in both improper and outright illegal Medicare payments the agency estimates it makes each year.
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