The Senate Finance Committee recently posted an open letter on its website to the health care sector soliciting industry stakeholder insights on ways to combat fraud, waste, and abuse in the Medicare and Medicaid programs. The letter comes shortly after the Committee held a hearing, which the members questioned government officials from the Department of Health and Human Services’ Office of the Inspector General (HHS-OIG), the Centers for Medicare & Medicaid Services, and the Government Accountability Office about the effectiveness of fraud-fighting efforts.
The open letter now invites a broader audience, including the private sector, to opine on the best ways to prevent and detect unlawful conduct and waste involving government health care programs. The Committee is requesting actors in the health care sector to submit “white papers” that address potential improvements in the following categories:
- Program Integrity Reforms to Protect Beneficiaries and Prevent Fraud and Abuse
- Payment Integrity Reforms to Ensure Accuracy, Efficiency and Value
- Fraud and Abuse Enforcement Reforms to Ensure Tougher Penalties Against Those Who Commit Fraud
The white papers should be submitted via email by June 29th to ProgramIntegrityWhitePapers@finance.senate.gov. The Committee members plan to have their staff review the white papers and then compile a summary document highlighting key proposals later in 2012.
This letter is the most recent instance where the government has sought the expertise of the private sector in addressing fraud, waste, and abuse. As we noted back in February, OIG issued a report related to the Pharmaceutical Compliance Roundtable, where it convened compliance professionals in the pharmaceutical industry.
At the roundtable, companies discussed their experiences with Corporate Integrity Agreements (CIAs) and other compliance efforts initiated by the government with HHS-OIG representatives. Prevention is becoming the new focus of fraud-fighting efforts, and the government needs private sector cooperation to achieve its goals in this area.