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Crackdown On Medicare Fraud Nets Record Settlement A crackdown on waste, fraud and abuse in Medicare is netting record settlements and improving the bottom line of the Medicare Part A Hospital Insurance Trust Fund. The Justice Department recently settled a Medicare fraud case involving a national chain of kidney dialysis centers for nearly $500 million, the largest such settlement in the department's history. In yet another high profile case, Beverly Enterprises, Inc., the nation's largest operator of nursing homes has agreed to pay $175 million to settle charges that it cheated Medicare out of $460 million from 1992 to 1998. A report released by the White House earlier this year indicates that the government won or negotiated more than $524 million in judgments and settlements in health care fraud cases in 1999. Of that, the government has collected $490 million, the bulk of which was returned to the Medicare Trust Fund. Medicare is also showing success in preventing fraudulent claims. Last year $5.3 billion worth of inappropriate payments were caught and prevented. President Clinton's fiscal year 2001 budget would expand the anti-fraud capabilities by placing federal agents in the offices of health insurance companies and other contractors that process Medicare bills. Last year the U.S. General Accounting Office found that at least eight contractors hired as the “first line of defense” against Medicare fraud were found to have integrity problems of their own, including the misuse of government funds. The proposal would also seek extra funds to finance new technologies to track false claims filed by health care providers.
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