Obamacare Uninsured against Healthcare Fraud

“The Affordable Care Act is the biggest new health care program in decades, but the Obama administration has ruled that neither the federal insurance exchange nor the federal subsidies paid to insurance companies on behalf of low-income people are ‘federal health care programs,’” which will exempt “subsidized health insurance from a law that bans rebates, kickbacks, bribes and certain other financial arrangements in federal health programs, stripping law enforcement of a powerful tool used to fight fraud in other health care programs, like Medicare,” as reported by The New York Times. This law, the federal Anti-Kickback Statute, is designed to protect patients and the federal health care programs from fraud and abuse by curtailing the corrupting influence of money on health care decisions. Notably, a violation of the Anti-Kickback Statute also constitutes a violation of the False Claims Act, which is the primary law on which the federal government relies to recover losses caused by fraud. "It is imperative that the anti-fraud provisions of the False Claims Act apply to all federal monies paid under Obama Care,” said Stephen Kohn, Executive Director of the National Whistleblower Center, and further stated,[the] decision to exclude certain companies participating in the Obama Care program from federal anti-kickback laws will cost the taxpayers billions of dollars.  I hope this was a mistake, and not the result of a back room deal with lobbyists for the medical industry." Similar sentiment was expressed by Republican Senator Chuck Grassley, a legislative trailblazer of whistleblower rights, in a letter to Health and Human Services Secretary Kathleen Sebelius as follows:

I’m alarmed that the Obama administration doesn’t understand the capacity for fraud in the new health care program....The head of the agency in charge doesn’t seem to appreciate that the billions of dollars in subsidies for individuals going to health insurers to join Obamacare are federal tax dollars.  Those dollars should be subject to anti-fraud laws.  Why wouldn’t they be?

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