Senators look to increase anti-fraud efforts, question recovery audits

Senate Finance Committee members recently called upon the healthcare community to suggest ways to strengthen the fight against Medicare and Medicaid fraud.

"To date, numerous efforts have been made to reduce fraud, yielding a mixed record of successes and failures," wrote several members of the committee in an open letter.

Once concern that came to light was that recovery audit contractor (RAC) functions frequently overlap with those of Zone Program Integrity Contractors. As McKnight's notes, RACs have been credited with identifying nearly $400 million in Medicare overpayments in fiscal year 2012 alone.

"We believe federal efforts would be strengthened by input from members across the healthcare community – providers, payers, health plans, contractors, nonprofit entities, consumers, data analytics entities, government partners and patients," wrote the group of six senators, which included committee chairman Max Baucus, a Montana Democrat. Interested stakeholders are invited to submit white papers by June 29 that detail areas for improvement and suggest new solutions for combating fraud. 

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