Originally published: February 23, 2010
Last updated: November 29, 2010 - 11:34am
President Barack Obama's plan to overhaul health care, which he outlined Feb 22, would create several new federal databases and information technology systems to identify and punish violations and frauds.
For example, the plan would establish a new "Comprehensive Sanctions" Medicare and Medicaid database that would be overseen by the Health and Human Services Department's (HHS) inspector general. The database would detail penalties levied against doctors, hospitals and suppliers and would be available to law enforcement agencies. It also would establish real-time analysis of claims and payments data for Medicare and Medicaid to identify apparently fraudulent claims in public health programs. "The President's Proposal speeds access to claims data to identify potentially fraudulent payments more quickly. It establishes a system for using technology to provide real-time data analysis of claim and payments under public programs to identify and stop waste, fraud and abuse," the proposal states.
The anti-fraud provisions also include plans to set up a system to match data from Medicaid and Medicare claims against Internal Revenue Service filings to identify whether a doctor collecting payments has a "seriously delinquent" tax debt.