Tighter Regulations to Prevent Health Care Fraud Against Elderly

On August 26, the Obama administration announced expanded federal enforcement efforts to crack down on health care fraud, which accounts for billions of dollars in costs each year to taxpayers. “The Centers for Medicare and Medicaid Services’ (CMS) new regulations are designed to prevent the most vulnerable among us – senior citizens – from being taken advantage of by ‘health care criminals’ who use technology as a means to their fraudulent ends,” says Michael Ruggio, a health care attorney and partner with Roetzel & Andress (Washington) who frequently represents medical device and pharmaceutical corporations involved in matters of fraudulent activity and abuse. “Under the new regulations, durable medical providers and other service providers must maintain detailed ordering documentation, including physician requests, and are required to demonstrate that they are legal and valid businesses.” The intensified scrutiny follows stories of fraudulent medical equipment and supplies vendors taking advantage of elderly clients by stealing physician identification and Medicare billing numbers to submit phony claims. “This increased regulation provides for greater transparency for physicians and other providers to make sure that a real medical professional is behind any requested order for treatment.” Mr. Ruggio is available to discuss the recently announced enforcement regulations and their impact on physicians, service providers and others in the medical field. He is also able to discuss how physicians and suppliers can protect themselves against fraud. [09/02/2010]