Congress takes aim at Medicare contractors
Congress is zeroing in on the Health Care Financing Administration's (HCFA) oversight of Medicare carriers in the wake of a $74 million settlement announced last week with Anthem Blue Cross and Blue Shield of Connecticut. Peter Sheffield, a spokesman for House Commerce Committee Rep. Tom Bliley (R-VA), says those hearings will likely coincide with release of a study by the General Accounting Office into HCFA's oversight of the 64 carriers that oversee the $217 billion Medicare program.
According to Stephen Robinson, the U.S. Attorney for the District of Connecticut, the settlement addresses Anthem's financial responsibility for fraudulent conduct by its predecessor, Blue Cross & Blue Shield of Connecticut, to conceal its failure to meet performance standards by falsifying cost reports. "This represents the largest civil settlement in a health care fraud case in Connecticut and the second largest involving a Medicare contractor in the history of the United States."
Bliley noted that seven major cases have already been brought against Medicare contractors resulting in more than $300 million in civil and criminal settlements.
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