Medicare Fraud Strike Force: Increasing Pressure For Recovery Efforts

February 7th, 2013

Since its development in 2007, the Medicare Fraud Strike Force has brought more than 1480 defendents to justice and uncovered over $4.8 billion in funds that were falsely billed to Medicare.  As impressive as these numbers are, Medicare compliance efforts are demanding an increase in the strike force's recovery efforts.  

Health care reform costs are projected to be very high, and there's a very real need to address the deficit that the country is facing.  There's never been a better time to begin to enforce a Medicare compliance task force, regardless of how big or small your medical setting is.  

CEO's are encouraged to put into place experienced compliance professionals that can oversee the Medicare billing procedures in hospitals and doctors offices.  However, for those individuals to be as effective as possible, their placement needs to be handled the right way.  There are a few things CEO's can do to empower compliance professionals that will enable them to find solutions to any issues they may find.

Establish Compliance Officer's Authority

This is probably the most important because without the power to manage a comprehensive compliance program, the Compliance Officer's role is undermined from the beginning.  Each Compliance Officer must be granted the power to make changes and to make them as quickly as possible.

Establish A Regular Reporting Schedule

CEO's should be meeting with Compliance Officers on a regular basis for the purpose of looking at compliance reports.  Regular reporting is the functioning element of any compliance program, and they shed light on issues that require immediate attention.  

Establish Routine Audits

In order to keep the program on track, audits should be performed by the Compliance Officer and the CEO on a regular basis.  This will prove whether or not the proper measures to fix Medicare compliance issues are being addressed in a timely manner.  When audits are done properly, they will also reveal anyone who might be standing in the way of full Medicare compliance.

At KLA Healthcare Consultants we take your medical billing seriously.  We are proud to be a part of The Healthcare Billing and Management Association, which holds high standards for their members with regard to Medicare compliance.  We're here to serve you in your billing needs and assist with any of your Medicare compliance questions.  For more information, contact us today.

Tags: Medicare Compliance


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