Senator Grassley focuses on 3rd Party Contractor’s failure to address significant Medicare Fraud
According to Senator Chuck Grassley, the Centers for Medicare and Medicaid Services' oversight of its contractors is too lax, facilitating hundreds of millions in fraudulent billings.
"I have been concerned and puzzled that CMS does not seem to examine its contractors' role in enabling taxpayer dollars to be misused or wasted and to hold contractors accountable if they fail to carry out their responsibilities as expected," Grassley explained in a letter dated Oct. 6, 2010.
The Office of the Inspector General found that $4.7 million in improper payments were made to health care providers in 2009. Forty percent of the inaccurate payments went to inpatient hospitals, while twenty-five percent went to durable medical equipment suppliers and twelve percent went to hospital outpatient departments. Seven percent went to physicians.
Grassley's letter references cites a 2004 lawsuit that resulted in a $445 million judgment against All-Med Billing Corp. and its owners, and wanted to know why there was no review of Medicare Administrative Contractor, Palmetto Governmental Benefits Administrator, for its role in enabling fraud, waste and abuse. As the letter notes, Palmetto GBA allowed millions to be paid to the DME companies for fraudulent claims.
To review the complete letter from Senator Grassley, click
here.
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