Hailing South Florida's crackdown on fraud as a model, President Clinton sent Congress a bill Tuesday that makes it tougher for health care providers to plunder from Medicare and Medicaid.
Gov. Lawton Chiles appeared with Clinton and Health and Human Services Secretary Donna Shalala for a briefing on the bill _ and touted Florida's success in punishing doctors and other providers who try to bilk the federal reimbursement system.
"Medicare fraud costs billions of dollars every year," Clinton said. "It amounts to a fraud tax that falls on all of our taxpayers, but most heavily upon our senior citizens."
Chiles was there to push the joint Florida-federal effort called "Operation Restore Trust," which the governor said will save nearly $200-million this year and next through a systematic effort "to weed out fraudulent providers and prevent future abuses."
One special Florida anti-fraud program, for example, studied suspicious billing practices and triggered inspections of some 19 laboratories, Chiles said. It uncovered $4-million in overpayments to facilities that did not even have the equipment to carry out the procedures for which the government repaid them.
"Florida's success in fighting health care fraud can and should be copied by other states," Chiles said. "Mr. President, thank you for your leadership in this war on fraud and abuse."
Clinton said the legislation sent to Congress on Tuesday should send a special signal to America's elderly about the nation's commitment to senior citizens.
"Medicare and Medicaid are more than just programs. They are the way we do honor to our parents, the way we strengthen our families, the way we care for our poorest and most vulnerable children," he said.
Medicare provides health care coverage to 38-million senior citizens and people living with disabilities. Medicaid is the state-administered program for the poor.
Shalala said her administration's two-year focus on cracking down on Medicare fraud had resulted in 69 convictions of people who collected repayments that they were not entitled to _ and the disqualification of 177 health care providers from Medicare and Medicaid reimbursement "because of their fraudulent actions."
One key aspect of the legislation, she added, would require health care providers to register their Social Security numbers with the federal government, to make it harder for scam artists to go from state to state setting up bogus facilities and collecting government funds.
It also would:
Punish doctors, criminally or through administrative penalties, who accept kickbacks when they recommend a Medicare and Medicaid patient to a specialist.
Make it more difficult for providers who are rejected from participating in Medicare or Medicaid to reapply for participation.
Create new civil monetary penalties for physicians, hospitals and other providers who falsely certify somebody for Medicaid or Medicare who is not eligible.
Close a loophole that has allowed providers to file for bankruptcy as a mechanism for avoiding fraud-related penalties.