Feds Begin Fingerprinting 'High Risk' Medicare Providers and Suppliers

weeklystandard.com ^ | April 15, 2014 | JERYL BIER

[ilovesarah2012]

Four years after Obamacare became law, the Department of Health and Human Services (HHS) is notifying Medicare providers and suppliers of new fingerprint-based background checks. Eventually, all individuals who hold a five percent or greater stake in a Medicare supplier or provider that is categorized as "high risk" will be subject to the requirement. The provision is part of the Medicare, Medicaid, and CHIP Program Integrity Provisions (Title E) of the Affordable Care Act, and gives the HHS secretary broad discretion in applying the background check requirements depending on the potential for abuse, fraud, and/or waste.

The new requirements are spelled out in a document posted online on the website of the Centers for Medicare and Medicaid Services (CMS) last Friday. The new rules will apply to both current and future enrollees who are classified as "high risk," the stated purpose being to weed out "bad actors" in the Medicare program and prevent any more from enrolling.

This particular document is a "News Flash" from CMS's Medicare Learning Network and is addressed to suppliers and providers who submit claims for "Durable Medical Equipment Medicare Administrative Contractors (DME MACs) and Home Health and Hospice (HH&H) MACs for services provided to Medicare beneficiaries." There is no effective date or implementation date listed on the document; rather, the document states that "fingerprint-based background check implementation will be phased in beginning in 2014," and that those affected will receive letters after which the individuals will have thirty days to comply with the finger-printing requirement. The fingerprints will be submitted to the FBI for a background check and will be stored by the government in accordance with federal requirements and FBI guidelines.

[driftdiver]

I wonder if this includes Soros who owns part of Wellcare. A company with a history of medicare fraud.

[b4its2late]

The tentacles reach deeper.

[Gaffer]

I’ve been fingerprinted over my career more times than I can remember. They first got them in 1968 in the military.

One thing they will never get from me willingly is DNA.

[Does so]

Many Medicare fraudsters in Florida now reside in Cuba—living like a king on their stolen millions.

[ilovesarah2012]

I am shocked Soros is still alive.

[uncitizen]

first the “providers” for “weeding out bad actors in the marketplace”, next the patients because they can ( they got their foot in the door already so just try to stop them)

[dennisw]

This could have, should have been done ages ago. Just the fingerprinting will drive away many of the frauds.

But really they need a decent computer with software that will kick back suspicious providers with a suspicious pattern of billing. For further scrutiny by the fraud squad. This should have been done ages ago and never has been

Such a computer wpuld not cost more than 10 million if they have an honest company build it, not some crony capitalists

[ilovesarah2012]

Exactly. Camel. Nose. Tent.

[ilovesarah2012]

I had forgotten about that. Found a good article.

http://www.bloomberg.com/news/2012-11-20/fraud-trial-for-wellcare-ex-ceo-shows-medicaid-program-abuse.html

[mazda77]

10 million. surely our jest. 100K would easily do the trick.

[SMARTY]

Ha! That requirement should be enforced for ALL government employees... including, everyone in Congress AND the WH!

[Mouton]

“Such a computer wpuld not cost more than 10 million if they have an honest company build it, not some crony capitalists”

Consider this: it would be the government doing this. Do you see any potential such a system would not cost over a billion and have more holes than a sieve.

[Ancient Man]

Political correctness and non-profiling keep the real criminals in business. They need to go after the foreign nationals from Nigeria, Pakistan, Russia and Armenia. They should never be given Medicare or Medicaid numbers because they are here for the express purpose of defrauding the government.

[dennisw]

10 million. surely our jest. 100K would easily do the trick.

This would be enough to cover the Medicare-Medicaid base of 355,000 providers and kick out the ones needing human scrutiny?

http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/DataAndReports.html
As of February 2014, more than 355,000 health care providers received payment for participating in the Medicare and Medicaid Electronic ...

[dennisw]

Political correctness and non-profiling keep the real criminals in business. They need to go after the foreign nationals from Nigeria, Pakistan, Russia and Armenia. They should never be given Medicare or Medicaid numbers because they are here for the express purpose of defrauding the government.

I know someone who likes to scan the news for this kind of fraud. At least 70% of the fraud is done by doctors and providers who have foreign names and don't seem to have been born in America. 

India
Pakistan
Lebanon
etc etc etc

[dennisw]

Lots of Hispanic last names too among the Medicare fraudsters!

[SunkenCiv]

We need to do that will elective office candidates and bureaucrats.

Thanks ilovesarah2012.

[Patriot Babe]

Right now I’m unemployed so I’m going thru a job site to check out some job. Well folks my jaw dropped when I saw this:

http://hire.jobvite.com/CompanyJobs/Careers.aspx?k=Job&c=qkx9VfwF&j=oHJMYfwU&s=Indeed

Please read the very first line on top of this job.

[Mears]

“India
Pakistan
Lebanon
etc etc etc “

—

Don’t forget Russia. We had a case of fraud some years ago in the Boston area and it involved Russians,who are all over the place since the early 80s.

.