Attorney General Eric Holder and HHS Secretary Kathleen Sebelius announced that a new interagency effort, the Health Care Fraud Prevention and Enforcement Action Team (HEAT), will be created to combat Medicare fraud. HEAT will expand the joint DOJ-HHS Medicare Fraud Strike Force teams that have been fighting Medicare fraud in South Florida and Los Angeles since 2007. The strike force teams use a “data-driven” approach to identify unexplainable billing patterns and investigate providers for possible fraudulent activity.
The HEAT team will also try to prevent fraud by building on demonstration projects by the HHS Inspector General and CMS that focus on suppliers of durable medical equipment (DME). These projects increase site visits to potential suppliers to prevent imposters from posing as legitimate DME providers. Other HEAT initiatives will include increasing training for providers so they can identify and prevent fraud; improving data sharing between CMS and law enforcement to identify patterns that lead to fraud; and strengthening Medicare Parts C and D compliance and enforcement.
