Clinton Plan Targets Abusers Of Medicare

Citing billions of dollars lost to taxpayers each year, President Clinton unveiled a proposal to root out scam artists who defraud the Medicare system.

In his radio address Saturday, Clinton outlined a multipronged plan to curb overcharging of everything from drugs to wheelchairs by medical suppliers.

“Medicare fraud is a real crime, committed by real criminals, intent on stealing from the system and cheating our most vulnerable citizens,” the president said.

Clinton announced a series of steps, which he said would save Medicare more than $2 billion over five years. They include:

Paying market prices for drugs.

Making medical equipment suppliers compete on price.

Doubling the number of audits for hospitals and nursing facilities.

Penalizing doctors that certify outpatient mental health and hospice benefits for patients that do not need them.

Putting Medicare at the top of the list of debtors to be repaid when fly-by-night providers go bankrupt.

The proposal will be included in the 1999 budget that Clinton will submit to Congress next month.

Clinton said existing anti-fraud efforts - assigning more investigators to go after cheaters and convicting dishonest providers and suppliers - yielded nearly $1 billion in fines and settlements for health care fraud in 1997.

Health and Human Services Secretary Donna Shalala said Friday that under current practices, Medicare pays substantially more than market prices for drugs and equipment because of its pricing structure, which was designed to attract doctors and suppliers into the system. In a study of 22 common drugs, the government found that Medicare paid more than double the average wholesale prices and, in one case, 10 times average prices.

“We’re overpaying for almost everything because we’re locked into a pricing structure,” Shalala said.