Trump Budget Would Boost Health-Care Fraud-Fighting Efforts


Presidential budgets are always scrutinized, analyzed, and ultimately revised, but some elements generate bipartisan support and end up happening. This might be the case with the Trump administration’s request for more health-care anti-fraud funding. The fiscal year 2018 budget request would boost spending on the Health Care Fraud and Abuse Control program to $751 million, $70 million more than was allocated for FY 2017.

Additionally, the budget calls for spending a total of $5.25 billion on health-care anti-fraud programs over the next 10 years, an increase from the Obama administration's $5.1 billion proposed funding in its FY 2017budget request. The Trump budget said the increased funding would lead to $11.7 billion in savings over the 10-year period, or a net savings of $6.4 billion.

The proposed boost in fraud-fighting funding is notable considering the overall Health and Human Services cuts the budget request calls for, Gejaa Gobena, a health-care attorney with Hogan Lovells told me. The HCFAC program coordinates federal, state, and local law enforcement activities related to health-care fraud and abuse, and the money is shared among the Centers for Medicare & Medicaid Services, the Department of Justice, and the HHS Office of Inspector General.

“It's clear that the administration sees HCFAC funding as worthwhile and a good investment, and there have been numerous reports that HHS's HCFAC partner, the DOJ, is also placing a very high emphasis on health-care enforcement,” Gobena said.

The increased anti-fraud funding is not surprising considering recent comments from administration officials, Linda Baumann, a health-care attorney with Arent Fox in Washington, told me. For example, Kenneth Blanco, the acting head of the Department of Justice’s criminal division, recently said Attorney General Jeff Sessions personally assured him that preventing the diversion of Medicare funds would be a DOJ priority, Baumann said.

Baumann said the budget also highlights the positive return on investment from anti-fraud efforts, including a recent 12-to-1 ROI on program integrity efforts and a 5-to-1 ROI on law enforcement efforts.

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