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Preventing and Reducing Improper Medicare and Medicaid Expenditures Act
By Dr. David Edward Marcinko MBA
http://www.CertifiedMedicalPlanner.org
This Act was introduced into congress in 2013 and contains a number of provisions that would increase rewards and incentives for those who uncover healthcare fraud, as well as heighten penalties for those who commit it.
The PRIME Act
The PRIME Act would enact stronger penalties for Medicare and Medicaid fraud; curb improper or mistaken payments made by Medicare and Medicaid; establish stronger fraud and waste prevention strategies with Medicare and Medicaid to help phase out the practice of “pay and chase” (i.e., recouping monies already erroneously paid to providers instead of detecting problems on the front end); curb the theft of physician identities; expand the fraud identification and reporting work of the Senior Medicare patrol; take steps to help states identify and prevent Medicaid overpayments; and improve the sharing of fraud data across state and federal agencies and programs.
Assessment
The law directs the Secretary to develop a plan to revise the incentive program under HIPAA for the reporting of fraud and abuse to encourage greater participation by individuals reporting Medicare fraud and abuse.
And, it also requires the plan to include certain recommendations for ways to enhance rewards for individuals reporting and an extension of the incentive program to the Medicaid program.
MORE: Ten Ways to Prevent Fraud [Consumer]
Conclusion
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Filed under: Ethics, Risk Management | Tagged: David E. Marcinko, HIPAA, Medicare and Medicaid, Medicare fraud, PRIME Act |
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