Select Page

Looking to cut waste and decrease the incidence of fraud, the Center for Medicare and Medicaid Services (CMS) and the Department of Veterans Affairs (VA) will now cooperate in the dissemination of best practices and the sharing of data analytics tools to improve their delivery of services.

A press release issued by the CMS reported:

CMS continues to focus on reducing and eliminating fraud, waste and abuse in Medicare, and in 2010, it established the Center for Program Integrity to help with this work. CMS estimates that its program integrity activities saved Medicare operations $17 billion in fiscal 2015. Other HHS combined efforts — including law enforcement — contributed to greater program savings.

VA plans to capitalize on the advancements in analytics CMS has made by concentrating on its use of advanced technology, statistics and data analytics to improve fraud detection and prevention efforts. Additionally, in November 2017, VA invited industry experts to provide information on the latest commercial sector tools and techniques to enhance VA’s fraud detection capabilities. In April, VA will invite these industry experts to demonstrate their capabilities for detecting and preventing fraud, waste and abuse and recovering improper payments.

The VA has long had been a source of controversy when it comes to alleged incidents of fraud and waste.

Only last January 10 this year, the VA union called on Congress to probe contractors running the Choice program.

From PRNewswire:

National President (J. David)Cox said in the letter that “The questionable practices used by third-party administrators of the VA Choice Program, TriWest and HealthNet, including double billing and improper payment rates, have directly harmed veterans and undermined the capacity of the VA health care system to provide them with the exemplary care that they have earned with their service.

The revelation of overcharging by third-party administrators is just the latest controversy plaguing the negligent Choice program. Last month, the House Committee on Veterans’ Affairs voted along party lines to pass H.R. 4242 – VA Care in the Community Act – which would continue to funnel funding away from veterans’ first and best choice for health care, sticking them in the back of the line at unaccountable, private, for-profit providers.