Health Reform Could Mean More Fraud Enforcement—And More Fraud

Authors of the report, Sara Rosenbaum, Nancy Lopez, and Scott Stifler, said the reason the public is more aware of Medicare and Medicaid fraud is because the government is required to tell taxpayers where their money is going. Most recently, Office of Inspector General Chief Counsel Lewis Morris told Congress that the United States lost $60 million to healthcare fraud in 2008, which was 3% of the government's budget.

Private insurance companies are not obligated to release such numbers so fraud involving those companies stay out of the headlines. The amount of money private insurers lost to fraud is reported to the board of trustees, not the public.

Fraud and abuse enforcement is much more significant on the public side as well. Just this year, President Obama allotted $311 million of the $3.4 trillion budget on healthcare fraud and abuse prevention. Enforcement was strengthened again with the creation of The Health Care Fraud Prevention and Enforcement Action Team.

"[Healthcare fraud enforcement] has been a theme we have seen in the president's budget and Medicare rule making," says Ed Dougherty, senior vice president of B&D Consulting.. "I would say regardless of what happens in healthcare reform, there will be increased focus in all sites of service."