Medicare Anti-Fraud Office to Open In Louisiana: Anti-Fraud Grants also Announced for Louisiana, New Jersey and Oregon
The Department of Health and Human Services today announced the opening of a new Medicare anti-fraud office in New Orleans, as well as $150,000 in grants to three states to help fight health care fraud and abuse and protect Medicare for the future.
"Fighting health care fraud and abuse is one of our highest priorities," said HHS Secretary Donna E. Shalala. "Protecting Medicare's integrity is more important than ever as we gear up to meet the needs of the coming Baby Boom generation."
Two HHS officials, testifying at a Senate Special Committee on Aging hearing in Baton Rouge, La., on the coming retirement of the Baby Boomers (those born between 1946 and 1964), said these are the latest steps in the department's anti-fraud efforts that helped return nearly $1 billion to the Medicare Trust Fund last year. Senator John Breaux, ranking minority member of the Senate committee and chairman of the new National Bipartisan Commission on the Future of Medicare, was conducting the field hearing.
Medicare is already achieving record success in increasing fraud and abuse investigations, indictments, convictions, fines, penalties and restitutions. Last year, nearly $1 billion was returned to the Medicare Trust Fund, thanks to partnerships between HCFA, the HHS Inspector General, Department of Justice and state and local authorities. Medicare alone saved an estimated $7.5 billion in FY 1997 -- mostly by preventing inappropriate payments -- through audits, medical reviews, and making sure other insurers who cover our beneficiaries pay claims that are not Medicare's responsibility.
The New Orleans anti-fraud field office will operate in the same way as the highly successful anti-fraud field office in Miami, Fla., working with federal and state program, law enforcement, private insurer and consumer advocacy groups to find, prosecute, and prevent fraud and abuse. The Louisiana office will also help coordinate anti-fraud efforts in other states, including Texas.
"We know from our success in Florida that this field office will make major inroads against fraud and abuse here in this region," said Nancy-Ann Min DeParle at the hearing. DeParle is administrator of the Health Care Financing Administration, which runs Medicare.
In the grants announced today by HHS' Administration on Aging, Louisiana is one of three states, along with Oregon and New Jersey, whose Offices on Aging are each receiving $50,000 from AoA to support Medicare and Medicaid anti-fraud efforts, especially by involving older Americans in anti-fraud efforts.
"These grants let states target resources where they know they can do the most good to fight fraud and abuse," said Assistant Secretary for Aging Jeanette C. Takamura at the hearing today. The three new states join 15 others already receiving such grants, made possible by the Health Insurance Portability and Accountability Act signed by President Clinton in 1996.
Both the new field office and the new grants add to the ground-breaking anti-fraud initiative Operation Restore Trust, a highly successful anti-fraud project pioneered by HHS' Health Financing Administration, the Administration on Aging, the HHS Inspector General and the Department of Justice in 1995.
New AoA Grants
Louisiana Governor's Office of Elderly Affairs, Baton Rouge, La. -$50,000
Louisiana will conduct a collaborative effort with the state unit on aging, Department of Health and Attorney General=s Office; the American Association of Retired Persons; the Senior Health Insurance Information Program (SHIP), Health Care Financing Administration; area agencies on aging and others. It will design a training package and "train the trainer" approach which will enable Louisiana aging network personnel and others to assist beneficiaries understand and identify discrepancies and reporting procedures. The state plans to develop an outreach campaign using printed materials; tracking instruments; training packages and videos, and other educational material.
New Jersey Department of Health and Senior Services, Trenton, N.J. -$50,000
The New Jersey Anti-Fraud Initiative will establish a coordinated federal-state-local approach to prevent fraud and abuse. The focal point of the New Jersey initiative will be the Inter-Agency Coordinating Council (IAC), which uses beneficiary education and outreach. A standard education curriculum will be developed for training New Jersey long term care ombudsmen, volunteer advocates, case managers, health facility surveyors, public guardians and other senior citizen groups and advocacy agencies. Through an existing partnership with Rutgers University, public awareness materials will be developed and disseminated to health care consumers, nutrition sites, senior centers and local area agencies on aging.
Oregon Senior and Disabled Services Division, Salem, Ore. -$50,000
Oregon Operation Restore Trust (OORT) is a coordinated program to combat health care fraud, waste and abuse through training, education, and direct counseling. OORT will conduct four in-state regional "train the trainer" events, and develop a series of shorter volunteer training workshops. In addition, OORT will conduct direct outreach to senior health care consumers and persons with disabilities, as well as create community coalitions to assist in this effort.