Eli's Rehab Report

Published on Thu Sep 24, 2009 PDF

You should have your eye on the RACs, the OIG, the IRS, and other Medicare/Medicaid auditors, but that's not all. The Centers for Medicare & Medicaid Services is taking its oversight up another notch with a new interagency strike force.

CMS and the Department of Justice have launched the Health Care Fraud Prevention and Enforcement Action Team -- also known as "HEAT" -- to combat fraud in the Medicare program, according to the Department of Health and Human Services.

CMS will expand its strike force team operation to target fraud locally in Detroit and Houston. The strike force already operates in South Florida and Los Angeles. Federal Prosecutors have indicted 115 cases with 257 defendants in Miami, Los Angeles, and Detroit since strike force operations started in March 2007.

Collectively, these defendants are alleged to have fraudulently billed the Medicare program for more than $600 million. The strike force teams will eventually spread to 10 other cities not yet named, the Associated Press reported.

"We know these strike forces work," said Attorney General Eric Holder in a statement.

Heads up: HEAT will take a special focus on durable medical equipment suppliers. Auditors will aim to "prevent impostors from posing as legitimate DME providers," according to a press statement. The HEAT team will be comprised of senior officials from DOJ and HHS.

The joint task force is also appealing to Medicare beneficiaries themselves to report fraud with a new Web site called "Stop Medicare Fraud" at www.hhs.gov/stopmedicarefraud.