The House of Representatives approved a bill that would prevent executives and managers involved in a Medicare fraud case from coming back and leading another company billing Medicare services.
Rep. Pete Stark (D-Calif.) sponsored the Strengthening Medicare Anti-Fraud Measures Act of 2010 to give HHS the power to permanently exclude any officer or managing employee involved in instances of fraud from the Medicare program. Currently, only individuals with an ownership or controlling interest of a company can be banned, the bill says.
The Miami Herald notes being exiled from the Medicare program is called the "kiss of death" by some in the health care industry.
"This bill is an important, bipartisan measure that will protect Medicare beneficiaries and taxpayers," Stark says. "It closes two loopholes that allow executives and corporations who defraud Medicare to keep doing business."
Stark's office says the legislation addresses two gaps in Medicare fraud policy:
- Executives from companies that are convicted of fraud can be excluded from Medicare under current law. However, if the executive has left the company by the time of conviction, he or she cannot be barred from federal health programs. These executives are able to move from one company to another and continue to defraud Medicare, seniors, and taxpayers. The bill would give the OIG the authority to ban these executives from doing business with Medicare.
- Companies that engage in fraud often set up shell companies to insulate themselves from liability. Criminal settlement negotiations can result in the dissolution of these shell organizations with no real penalty to the parent company. The bill gives OIG the authority to exclude these parent companies from the Medicare program.
The bill will now go on to the Senate for consideration.