New Medicare Billing System Part of Small Business Lending Act
According to reports, the Small Business Lending Act signed into law this past June includes an anti-fraud provision that will require Medicare to do more to prevent fraud.
“Medicare fraud has been a problem for far too long,” notes Alan Weinstock, insurance broker at MedicareSupplementPlans.com. “CMS uses an outdated billing system which I understand actually helps to facilitate over $60 billion in Medicare fraud annually.”
Under the new provision, the Centers for Medicare and Medicaid Services (CMS) will be required to stop its long-held policy of approving claims without first verifying them.
Medicare Billing Software
Part of what the law implements is new Medicare billing software with a predictive modeling component, a type of analytical technology that already has been adopted in the credit card industry to identify potentially fraudulent bills. Medicare billing contractors will be required to use the new technology for hospitalization and outpatient services, which make up the bulk of Medicare’s spending. It is estimated that predictive modeling could save the government more than $20 billion a year.
CMS is required to launch a competitive bidding process by January 2011 for predictive modeling software contractors and then begin actually implementing the technology by July in the 10 states with the highest Medicare fraud rates.
After the first year of implementation, Health and Human Services will be required to submit a report to Congress detailing the actual savings on Medicare fraud. If the savings are substantial, some of that money could be used to implement the technology in 10 more states.
Small Business Lending Act
The Small Business Lending Act is intended to free up credit so small business owners can grow their operations, hire more workers, and help improve our economy, or so say those who supported its implementation.
What many small business owners face is the lack of available loans from major banks who are currently withholding monies. This Act is intended to increase the number of businesses who qualify for funds while it increases the maximum amount of money that the Small Business Administration (SBA) can lend. However, detractors indicate that the bill does little to correct the unfriendly policies and that tax cuts and repealing measures that increase costs will do more to end the recession.
Also included in the bill along with the Medicare anti-fraud initiative is the export promotion provision. This provision is intended to increase the activities and staffing of the Department of Commerce in carrying out its mission to promote U.S. exports.
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