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Date:  August 11, 1995
For Release:  Immediately
Contact:  HCFA Press Office (202) 690-6145

HCFA Plans Three "Listening Sessions"
This Month to Help Fight Fraud and Abuse
in Medicare and Medicaid

Officials of the Health Care Financing Administration have scheduled three "listening sessions" this month in different cities, to help find new ways of reducing fraud and abuse in the Medicare and Medicaid programs.

Senior managers -- members of HCFA's program integrity group -- will meet with representatives of insurance companies, health care providers and beneficiary organizations, who have been asked to present their views on reducing the programs' vulnerability to abuse. The meetings are planned for Aug. 14, in Longmont, Colo.; Aug. 17, in Boston, Mass.; and Aug. 29, in Washington, D.C.

"American citizens, and Medicare and Medicaid beneficiaries, deserve assurance that each benefit dollar is being spent for needed care and services," said HCFA Administrator Bruce C. Vladeck, who oversees the Medicare and Medicaid programs.

"HCFA works closely with its partners in the private sector and the states to fight fraud and abuse," Vladeck said. "In the past two years, HCFA has pioneered initiatives aimed at prevention, early detection and coordination."

HCFA's primary prevention goals concentrate on paying the right claims for the right services in the first place, thus avoiding opportunities for fraud and abuse.

Another effective means of preventing fraud and abuse is through educating providers, beneficiaries and Medicare claims contractors. For example, providers need information about what services are covered, and proper billing practices.

Medicare beneficiaries can be HCFA's "eyes and ears," Vladeck said. When beneficiaries have information confirming services provided to them and know what has been paid by Medicare, they can report any incorrect information to Medicare.

Medicare and Medicaid work closely with the agencies that have major responsibility for enforcement actions, referring cases and supporting their activities. These agencies include the HHS Office of the Inspector General (IG), the Department of Justice, the FBI and the U.S. attorneys' offices.

Medicaid programs are administered by the state Medicaid agencies. These agencies cooperate with the state Medicaid fraud control units, which receive federal and state funding. The IG, the FBI and the U.S. Attorney's office are also involved in investigation and prosecution.

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