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Can technology end Medicare fraud?

The Office of Inspector General recently issued a report card for the Department of Health and Human Services. It said that while HHS met many of the requirements in a 2002 law to curb improper payments, it did not fully comply for fiscal 2016. The Inspector General urges HHS to renew its focus on feasible ways to drive the rate of improper payments below 10 percent.

Some people think technology can provide a way to end Medicare fraud and improper payments. A bill before Congress -- the Medicare Common Access Card Act of 2017 -- would require the launching of pilot programs to test smart cards designed to deter, detect and prevent Medicare fraud.

An essay on the Texas Dentists for Medicaid Reform by the CEO of a company marketing smart cards insists that the technology can quash "the root causes of frauds." He writes that criminal activity "thrives in the dark" and that smart technology brings Medicare billing into the light.

The smart cards would authenticate exactly where and when health care services are rendered, so that Medicare officials would be able to determine if claims for payment are legitimate or not.

The GAO estimates that smart cards would cut fraud by 22 percent. While those marketing smart-card technology think the estimate is low, they point out that their products would cost about 1 percent of the 22 percent fraud figure.

While we are not in a position to endorse or reject smart card technology, it's clear that if the cards' proponents' claims are accurate, the technology would certainly bolster the defenses of those providers who made bookkeeping errors but were nevertheless accused of Medicare fraud.

If you or your company is under investigation for matters involving allegations of health care fraud, discuss your options with an experienced health care law attorney.

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