Medicare contractors are being asked for more information regarding how they identify and report fraud. This questions was brought on by a series of reports that contained inefficiencies in their fraud reporting procedures. The lawmakers requesting this information are asking medicare contractors for the following information: data from 2007 showing the number of fraud investigations initiated and the number of over payments identified, a description of factors influencing this date, policies and procedures about how investigations are initiated, policies and procedures describing how and when leads regarding Medicare and fraud are referred to law enforcement agencies, and policies and procedures for new payment suspension requests.
Fraud expert, Linda Webb, aka The Fraud Dog, who used to work as a Medicare fraud contractor, says these private contractors are moving too slow. By the time these contractors identify the millions of dollars of fraudulent overpayments, most fraud perpetrators are long gone. Yet the contractor claims the savings as identifying the overpayment. The money has already gone out the door. Activate the SWARM™, says the Fraud Dog. Swift Working Assessment with Rapid Methodology, meaning we have to attack on the front end BEFORE the money goes out the door instead of attempting to collect from the fraud perpetrator afterwards. It is time we moved swifter and faster on the front end in order to stop Medicare fraud. We must make sure that if the perpetrator is caught, we freeze their ability to sell their data to the next fraud perpetrator that can start the scam all over again. Fraud perpetrators are selling their data while running from the law as a fugitive or even when in jail. Data is king and we have got to stop the perpetrator from continuing the scams.
To report potentially fraudulent activity, contact Linda Webb aka The Fraud Dog, leading fraud expert at 1-855-FRAUD-DOG.