Medicare Faqs

Will There Be Stiffer Penalties for Those Committing Medicare Fraud Under the Affordable Care Act (ACA)?
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Yes. The Affordable Care Act imposes stricter penalties to deter and punish Medicare fraud. These include:

  • Excluding providers and suppliers who lie on their application to enroll in Medicare or Medicaid to be excluded from the programs
  • Subjecting providers who identify an overpayment from Medicare or Medicaid but do not return it within 60 days to new fines and penalties
  • Enabling providers who are terminated from Medicare, a state’s Medicaid program, or both to be terminated from Medicaid programs in other states
  • Increasing the federal sentencing guidelines for health care fraud offenses by 20-50 percent for crimes that involve more than $1,000,000 in losses
  • Making obstructing a fraud investigation a crime 
  • Making makes it easier for the DOJ to investigate potential fraud or wrongdoing at facilities like nursing homes
  • Establishing new penalties for Medicare Advantage (Part C) and Part D plans that violate marketing regulations or submit false bids, rebate reports or other submissions to CMS

Related FAQs

How Does the Affordable Care Act (ACA) Change the Way the Government Fights Medicare Fraud?

What Are the Key New Tools for Detecting and Preventing Medicare Fraud?

How Much Is Spent on the Government’s Efforts to Fight Medicare Fraud, Waste and Abuse Each Year?

Who Are the Members in Congress to Watch Regarding Medicare Fraud?

What Are the Events to Look for in Medicare Fraud, Abuse and Waste in 2012?

 






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