Department of Health and Human Services

A Way to Stop Medicare Fraud:

THE PROBLEM: An estimated 20% of all Medicare claims are fraudulent. That’s $60 to $80 Billion annually. THE SOLUTION: Under the Bank Secrecy Act (BSA), banks and other financial institutions are required to report suspicious financial activity and large cash transactions to the Treasury Department. This data helps law enforcement go after financial criminals. This data is an under-utilized tool that should be used by the government to detect Medicare fraud. For every Medicare claim submitted by a healthcare provider, the government should always check the provider’s name (and other relevant information) against existing BSA data. Whenever there’s a match, law enforcement should investigate and prosecute.

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Idea No. 3591