US Initiatives To Crack Health Care Fraud

US President Bill Clinton has announced new steps to strengthen thegovernment's enforcement efforts in the fight against health care fraud. Also, the Pharmaceutical Research and Manufacturers of America has given the state of Florida a grant of $200,000, matchable against federal dollars, to prevent and punish Medicaid fraud.

The immediate scope of the President's initiative is rather narrow, specifically aiming to prevent doctors who have lost their license to practice in one state from moving to another and collecting federal funds for providing services. It adds teeth to existing enforcement efforts, eg by requiring health care providers to list their Social Security or Employer Identification numbers when applying to participate in Medicare or Medicaid programs, thus aiding the Health Care Financing Administration in weeding out those with a history of fraudulent activity.

Congress' General Accounting Office estimates that fraud and abuse account for 3%-10% of all Medicare outlays, totaling $6-$20 billion of 1996's total $197 billion Medicare payments.