Senator Responsible for Whistleblower Laws Seeks Stronger Regulations

Iowa Senator Chuck Grassley last week introduced a wide-ranging bill to prevent fraud, abuse and waste in the Medicare and Medicaid programs. Grassley said the Strengthening Program Integrity and Accountability in Health Care Act is made up of reforms endorsed by both sides of the aisle. Senator Grassley led the development of a number of these provisions during the bipartisan work in the Senate last year on comprehensive health care legislation.

Senator Grassley outlined his plan to:

• Deter fraud with enhanced screening to improve the governments ability to keep fraudulent providers from participating in these programs from the start;
• Limit tax dollars lost to fraud by giving the government more time to evaluate the legitimacy of Medicare providers before payment is required when fraud, waste and abuse is suspected that is allowed under the existing pay-and-chase model;
• Strengthen the governments ability to detect fraud with better disclosure requirements;
• Enhance coordination among federal agencies responsible for fighting fraud, including sharing data sources; and,
• Improve enforcement capabilities by expanding the range of activity subject to penalties and toughening existing penalties.

“This bill brings together common sense, bipartisan initiatives to fight fraud, waste and abuse in taxpayer-sponsored health care programs, which all face serious budgetary challenges”, Senator Grassley said.

Notably, this proposed legislation includes portions of bipartisan legislation Grassley introduced months ago to fortify the Federal False Claims Act (FCA). These measures are a response to Federal court decisions that have significantly limited the scope and applicability of the FCA. Senator Grassley, who was the original principal author of many whistleblower laws passed in 1986, argues that this would restore Congress’ original intent.  In the past few decades, over $22 billion have been returned to the U.S. Treasury from FCA-related litigation and settlements. The FCA is the primary civil enforcement tool used by the U.S. Department of Justice in addressing civil health care fraud violations and concerns.

Should you have any questions regarding these issues, don’t hesitate to contact us.  For a complementary consultation, you may call Robert W. Liles or one of our other attorneys at 1 (800) 475-1906.