Obama administration touts federal efforts to combat health care fraud

The Los Angeles Times: Obama administration officials at a meeting in Los Angeles Thursday touted their efforts to crack down on health care fraud, "saying quickly expanding criminal enterprises are costing taxpayers billions of dollars each year. ... Atty. Gen. Eric H. Holder Jr. and Health and Human Services Secretary Kathleen Sebelius said their agencies were jointly targeting fraud in the federal Medicare and Medicaid programs. They said the initiative, launched in May 2009, had so far produced more than 580 criminal convictions and recovered more than $2.5 billion in fraudulent proceeds." Along those lines, Sebelius also said a Medicare regulation issued Thursday will "require suppliers of prosthetics and other items to maintain proper ordering documentation and to remain open to the public at least 30 hours a week. It also will bar such companies from using cellphones or pagers as primary business phone numbers" (Girion and Helfand, 8/27).

Chicago News Cooperative/The New York Times: "Dr. [Sushil] Sheth was recently sentenced by a judge in Chicago to five years in prison for ripping off Medicare and private insurers for at least $13 million — and possibly closer to $20 million. It's a tale of elaborate fraud that raises questions about both basic government competence in overseeing health care and our news media priorities when deciding what's news. … Starting in 2002, Dr. Sheth's inclination to spend lots of time with patients apparently melded with a desire to make tons of money. With privileges at Advocate South Suburban Medical Center, Ingalls Hospital and a third unidentified hospital, he was able to gain access to personal and insurance information about the patients" (Warren, 8/26).

The Los Angeles Times: Meanwhile, "[a] Rowland Heights physician suspected of illegally dealing prescription pain medications and other powerful narcotics to addicts — some of whom died of overdoses — said she is being made a scapegoat and that the responsibility for any misuse of the drugs belongs to the users. … In a federal search warrant affidavit, investigators said they suspected [Dr. Lisa] Tseng of routinely prescribing oxycodone, a powerful narcotic pain reliever similar to heroin, and other highly abused medications to drug-seekers without properly assessing their medical need or their apparent addictions" (Girion and Glover, 8/27).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.