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Home / Blog Health Care Fraud / Healthcare Fraud Post-ACA

Healthcare Fraud Post-ACA

September 16, 2015

Healthcare Fraud After the Affordable Care Act| Behn & WyetznerACA (the Affordable Care Act) expanded healthcare coverage to millions of low-income Americans and put in place numerous reforms within the health insurance sector. Currently, updates to healthcare delivery systems and financing methodologies implemented since ACA was enacted are predicted to result in dramatic reductions in unnecessary medical care in this country. But still, an avalanche of fraud continues to harm healthcare programs, and in particular government programs like Medicare and Medicaid.

Fortunately, powerful anti-fraud provisions in ACA and the False Claims Act have led to revocation of billing privileges for tens of thousands of providers who cheated the government, and Medicare claims are now routinely screened using advanced computer algorithms before being paid. These measures, combined with continued financial incentives for qui tam whistleblowers (called “Relators” under the False Claims Act), will help prevent healthcare fraud and ensure that healthcare coverage post-ACA is provided in a reasonable and cost-efficient manner.

Filed Under: Health Care Fraud

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Linda Wyetzner is a founding partner of Behn & Wyetzner, Chartered. She is a seasoned trial lawyer and negotiator, currently specializing in representing citizens who have reported fraud under the qui tam provisions of the federal and state False Claims Acts.  Ms. Wyetzner was a lead attorney in three groundbreaking pharmaceutical qui tam cases against Omnicare, CVS and Walgreens. Ms. Wyetzner has substantial experience with false claims act cases involving fraud in a diverse range of fields including fraud in the pharmaceutical, healthcare, telecommunications and defense contracting industries as well as NIH grant fraud.  Read more.

Read more articles by Linda Wyetzner

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