NCPA - National Center for Policy Analysis


June 12, 2009

Congress is kicking off the most significant health care debate in a generation.  But while there are major partisan divides over how to permanently restructure our health care system, there is one key area where Democrats and Republicans should be working together: fighting health care fraud, say Newt Gingrich, former Speaker of the House, and Jim Frogue, state project director at the Center for Health Transformation.

To make serious strides in the fight against fraud, lawmakers can start with the following three steps, say Gingrich and Frogue:

  • Immediately make public all Medicare and Medicaid claims data, but only in a manner that vigorously protects patient privacy; according to a 2008 poll, 98 percent of Americans believe they have the "right to know" cost and quality data about their health care provider, but it must be absolutely clear that public release of claims data should only occur after patient identities are safe beyond any doubt.
  • Ensure that Medicare patients with the most extreme outlier claims have access to the newest and best disease management plans.
  • Crack down on criminals by dramatically expanding the scope, use and distribution of the U.S. Department of Health and Human Services Office of Inspector General's (HHS OIG) exclusion list, which publicizes those individuals convicted of health care fraud.

Fraud is a destructive tax on Americans in need of health care services.  Fortunately, Congress can move decisively with bipartisan backing to eliminate much of that fraud. Done right, savings would be in the 12 figures annually, say Gingrich and Frogue.

Source: Newt Gingrich and Jim Frogue, "Gingrich and Frogue: Congress Must Eliminate Fraud," Roll Call, June 8, 2009.

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