The Affordable Care Act and Fighting Fraud
The Affordable Care Act, the health care law, takes powerful steps toward combating health care fraud, waste, and abuse. The government has recovered a record-breaking $10.7 billion in recoveries of health care fraud in the last three years. Some of the new tools the Affordable Care Act has put in the hands of fraud fighters:
- Tough new rules and sentences for criminals: The law increases federal sentencing guidelines for health care fraud by 20-50% for crimes with over $1 million in losses.
- Enhanced screening: Providers and suppliers who may pose a higher risk of fraud or abuse are now required to undergo more scrutiny, including license checks and site visits.
- State-of-the-art technology: To target resources to highly suspect behaviors, the Center for Medicare & Medicaid Services now uses advanced predictive modeling technology.
- New resources: The law provides an additional $350 million over 10 years to boost anti-fraud efforts. Learn more about how the Affordable Care Act fights fraud.