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Regional Health Care Fraud Summit

Miami, FL
July 16, 2010

Thank you, Attorney General Holder. And thank you all for joining us today.

We’re gathered here this morning because when this Administration took office a year and a half ago, we saw that the old way of fighting health care fraud wasn’t working. Our resources weren’t keeping up with the problem. Our technology wasn’t keeping up.

The criminals who committed health care fraud were getting organized, but our response – both within government and outside government – was often fragmented among parties that didn’t have easy ways to share information or ideas with each other.

The result was that there was a growing “hidden tax” on every American with health insurance. To make up for the resources scam artists were draining from the system, we were all paying more and receiving fewer benefits with no end in sight.

This kind of waste and fraud is never acceptable. But at a time when health care costs are rising three times faster than wages and setting our federal budget on an unsustainable trajectory, we knew we had to dramatically step up our efforts to stamp out waste, fraud, and abuse in our health care system.

As you just heard from Attorney General Holder, that’s exactly what we’re doing.

The arrests today were made possible in part by the additional resources the President and Congress have put into fighting health care fraud over the last year. And we’ll be able to keep the pressure on thanks to new funding in the Affordable Care Act that will help us put more boots on the ground in fraud hotspots across the country.

But we can’t turn the tide on health care fraud with more resources alone. We’ll also need stronger partnerships inside and outside government, smarter approaches to identifying and ultimately preventing fraud, and more support to help doctors and patients recognize and report suspicious activity.

That’s why we’re hosting this summit today. And it’s why in the coming months, we’ll hold similar summits in six other cities across the country. We want to start a national conversation about how we can work together to force criminals out of our health care system.

And there’s no better place to move that conversation forward than here in South Florida.

Recently, our department has begun a series of anti-fraud pilot projects here that we believe could eventually grow into national models.

One problem with efforts to reduce fraud in the past has been that when beneficiaries didn’t know what to do when they noticed suspicious activity. To solve that problem, we’ve created a new South Florida health care fraud hotline.

We’ve put that number on every Medicare Summary Notice we mail out in the Miami area. And we’re sending those Notices every month, so beneficiaries can quickly learn if someone’s fraudulently billing Medicare using their information.

This hotline has already led to investigations that have returned millions of dollars to Medicare and revoked the Medicare numbers of more than 20 corrupt providers.

We’re also strengthening our review process for providers and suppliers in high-risk areas. Over the last two and a half months, two of our regional Medicare contractors have completed over 1,600 onsite visits for these providers and suppliers, with over 500 of those visits leading to a Medicare number being revoked or deactivated.

Finally, last night we announced that our department has approved a request by the State of Florida to get access to Medicaid data so they can use data mining techniques to identify suspicious patterns in claims. Old law enforcement tactics like relying on tipsters are still effective, but with $2.5 trillion a year in health care spending, we need to give investigators better tools.

With your help, we believe these new approaches combined with new resources can help turn the tide on health care fraud in South Florida. But we also hope they will spread to the rest of the country.

As Attorney General Holder mentioned, the Affordable Care Act is secretly one of the strongest health care anti-fraud bills in American history. In addition to adding new funding for our crack down on fraud, it strengthens screenings for health care providers who want to participate in Medicaid or Medicare, makes it easier for law enforcement to see health care claims data from different government agencies in one place, and increases the penalties for fraud.

That means the for a potential criminal, it’s harder to submit false claims; you’re more likely to get caught if you do; and when you get caught, you’re going to face a much tougher punishment.

We have a special obligation to safeguard Medicare. Seniors have worked hard to earn their health benefits, and they deserve to know that we’re doing everything possible to protect them.

That’s why President Obama has made a bold commitment to eliminate half the waste, fraud, and abuse in Medicare. Part of that is working with doctors to reduce paperwork errors, a goal that will be easier to achieve thanks to the historic investment we’ve made in electronic health records. But we must also continue to build on these renewed efforts to stamping out fraud.

And those actions can’t just come from government. Over the last few months as seniors have been bombarded with a new wave of scams trying to exploit the Affordable Care Act, we’ve launched a major effort to empower Medicare beneficiaries to recognize and report fraud.

Working with groups like our department’s Senior Medicare Control and in conversations with seniors across the country, we’ve worked to give them the tools they need to play an active role in pushing scammers out of Medicare.

When you leave today, we’ll have fact sheets in English, Spanish, Russian, and Creole that you can take with you and distribute. And I also encourage people to visit our website where you can get information about how to protect yourself from fraud.

For years, we tolerated health care fraud. We accepted that with any big enterprise, there was going to be some waste.

Those days are over. As we try to bring down skyrocketing costs across our health care system, we can’t afford to ignore the billions of dollars we lose to simple theft. At a time when families are struggling to make every dollar count, we must too.

As the Attorney General pointed out, we have some evidence that the new resources and approaches we’re using to attack fraud are paying off. That’s encouraging. But we have a long way to go.

Working together, we can make a difference. Today, South Florida is often the answer when someone asks where they should go to see health care fraud. Tomorrow, it could be the answer for where to go if you want to stop health care fraud.

So thank you again for being here. I look forward to seeing what ideas come out of your discussions. And I look forward to continuing this conversation as we work to free our health care system of waste and fraud.

Thank you.