One little-noticed provision of the federal Affordable Care Act that is now having major effects was the institution of stronger penalties for Medicare and Medicaid fraud along with better anti-fraud enforcement across the health system. The new health law upped penalties for fraud, especially in losses over $1 million, financed new sophisticated computer systems to track claims to find fraud early, and set up mechanisms to encourage coordination between the Department of Justice and health care agencies.
These behind-the-scenes commonsense changes may not play into all the breathless political posturing around the health care law but these stricter rules are already producing results in NC. The Charlotte Observer reported that a Charlotte counselor was arrested yesterday and accused of at least $650,000 in fraudulent NC Medicaid claims. Already in related cases two other women have pled guilty, recieved prison time, and have been ordered to pay over $1.4 million in restitution.
The money we save from combating fraud in our public health programs goes to keeping health care affordable and available for those who really need help. This is one more reason we need to keep implementing the new health care law on track in NC – it’s working.