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Health care reform is working
President Obama’s health care reform legislation takes real steps to rein in waste and fraud in the system and put us on a more sustainable path while reforming the insurance industry and providing access to coverage for the uninsured.
Weeding out waste, fraud, and abuse from our health care system is one of the best ways to improve efficiency and stop the meteoric rise of cost. Many fraudulent claims go undetected and Medicare fraud is considered to be so widespread that it is estimated to cost taxpayers more than $60 billion dollars each year. The health care reform law contained several provisions to crack down on fraud and abuse, including the creation of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint effort by the Departments of Health and Human Services (HHS) and Justice (DOJ) to identify, investigate, and prosecute health care fraud.
The HEAT recovered more than $4 billion in fraudulent claims last year, bringing its overall recovery total to nearly $15 billion in four years. The HEAT’s return on investment is startlingly impressive – for every dollar spent investigating and prosecuting criminals, it claims $7.90 in benefits. These recovered funds get reinvested into the Medicare Trust Fund and the U.S. Treasury.
The success of HEAT is just one of the ways the President’s health care reform legislation is chipping away at the burdens Americans face when finding the care they need. One of the most debilitating health care costs – the price of prescription drugs – sits disproportionately on the shoulders of senior citizens.
A hallmark victory of the health care reform bill is that it closes what’s known as the prescription drug “donut hole” that affects millions of Medicare beneficiaries. In 2010, the first year of implementation of the new health care law, Medicare beneficiaries in the “donut hole” received a one-time $250 rebate. In 2011, these beneficiaries began receiving a 50 percent discount on covered brand name drugs and coverage for 7 percent of the cost of generic drugs in the coverage gap. Last year, coverage of these generic drugs rose to 14 percent and will continue to rise until 2020 when the hole is fully closed.
This means that more than 6.1 million seniors and people with disabilities have saved over $5.7 billion on prescription drugs since we began implementation of the reform measure. In 2012 alone, Medicare beneficiaries in the “donut hole” saved $2.5 billion, or an average of $706 per beneficiary. This is fantastic progress.
I am committing to our continued effort to improve health care in America. We’ve already had many successes, but I will continue working hard to strengthen our system and ensure that every person has access to the care they need.
For more information, visit http://www.healthcare.gov/news/factsheets/2012/02/medicare-fraud02142012a.html
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