government

Medicare fraud penalties tougher under proposed bill

The legislation would hike fines and jail time for those who cheat the Medicare system.

By Chris Silva — Posted April 29, 2010

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Saying that criminal penalties for Medicare fraud must be updated, two Florida lawmakers introduced a bill April 13 that would double fines, increase background checks and even study how biometric technology could help ensure the appropriate use of program services.

U.S. Reps. Ileana Ros-Lehtinen (R, Fla.) and Ron Klein (D, Fla.) said the Medicare Fraud Enforcement and Prevention Act is "a tough new bipartisan bill" that will help crack down on Medicare fraud, protecting seniors and taxpayers alike.

The lawmakers said the legislation updates two key provisions in the criminal code to fight Medicare fraud -- the false statements and anti-kickback statutes in the Social Security Act. Penalties for those violations have not been updated since 1977, and criminal conspiracies against Medicare have increased dramatically since then, they said.

The act would double criminal penalties for false claims and violations of the anti-kickback statute from five years to 10 years, and increase fines from $25,000 to $50,000. It also would create a new type of offense for illegally distributing a Medicare or Medicaid beneficiary's ID or usurping someone's billing privileges, establishing a maximum penalty of three years in prison and a fine. Criminal background checks, fingerprinting and random site visits for suppliers and physicians considered to be high risk also would be implemented to ensure that they're running legitimate businesses.

In addition, the bill would direct the Dept. of Health and Human Services secretary to conduct a pilot program using biometric technology to ensure that beneficiaries are physically present to receive certain services billed to Medicare.

"The best way to save seniors and taxpayers money while keeping Medicare strong is to get tough on criminals and stop crimes before they start -- and that is why our bill does both," Klein said. "This innovative, bipartisan solution will help ensure that crooks can no longer open fake businesses or submit false paperwork to steal tens of billions of dollars a year from senior citizens and taxpayers."

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