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Feds gain power over billions in Medicare fraud

USA Today, September 20, 2010
Proposed regulations being unveiled today seek to crack down on Medicare and Medicaid fraud by subjecting operators of certain medical firms to fingerprinting and stopping payments when credible fraud allegations are made, documents show.

The rules would give federal health officials key powers to identify fraud early and reduce the estimated $55 billion in improper payments made each year in the Medicare and Medicaid programs, said Peter Budetti, director of the new anti-fraud office at the federal Centers for Medicare & Medicaid Services.

"Our initiative will allow us to go beyond what we've always called 'pay and chase' and to actually have the tools and mechanisms to prevent much of the fraud we've seen in recent years," Budetti said in an interview Sunday with USA TODAY.

Nora Super, a director at AARP, which advocates for seniors whose health care is paid for by Medicare, praised the rules. "AARP members tell us they see fraud all the time in the form of items on their bills that were never ordered, supplies never received and services never rendered," she said.

The proposed rules are part of the nation's new health law, which plans to expand coverage to millions of Americans in part by saving money on waste and fraud in the public and private health care systems. It's not known how much money these proposed rules would save, Budetti said.

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