Medicare fraud, costing Americans and insurance companies an estimated $100 billion in 2023 alone, continues to be a major issue nationwide. In response, Representative Aaron Bean (R-FL) has introduced new legislation aimed at closing loopholes that have allowed fraudulent billing practices to flourish, particularly by non-physicians exploiting the system.
Bean’s proposed Medical License Verification Act seeks to address a critical flaw within the Centers for Medicare and Medicaid Services (CMS) system. CMS currently issues healthcare providers a 10-digit National Provider Identifier (NPI) code, which grants them the ability to submit claims to insurance companies. However, according to Bean, this system lacks rigorous verification measures, potentially enabling individuals who are not healthcare providers to obtain NPI numbers and submit fraudulent claims.
In a press release, Rep. Bean highlighted the need for more stringent verification processes, stating, “Millions of Floridians rely on Medicare and Medicaid, but rising fraud and abuse threaten to undermine these programs and drive up healthcare costs. This bill represents a small but necessary step to protect our healthcare programs and prevent bad actors from defrauding Florida families.”
The Medical License Verification Act would mandate CMS to thoroughly verify that medical licenses are valid and in good standing before issuing NPI numbers, a move aimed at preventing fraudulent actors from exploiting the system.
This is not Bean’s first legislative effort to combat healthcare fraud. In August, he introduced the Prompt Reporting and Oversight for Medicare Providing Transparency (PROMPT) Act, which requires the Secretary of Health and Human Services (HHS) to report every new furnishing of an item or service within 30 days. The PROMPT Act is designed to enhance transparency and accountability within Medicare, providing a potential solution to reduce the staggering amount of fraudulent Medicare spending.
“Rising fraud and criminal activity threaten to undermine the Medicare system for Northeast Floridians. We have an obligation to ensure that taxpayer dollars keep our most vulnerable populations healthy, not lining the pockets of fraudsters. By increasing reporting, we can make significant strides toward addressing this growing problem and protecting Americans,” said Bean.
Both the Medical License Verification Act and the PROMPT Act underscore Bean’s commitment to tackling healthcare fraud head-on. These legislative measures, if enacted, could prove to be significant in curbing the abuse of Medicare and Medicaid, ultimately safeguarding healthcare resources for Americans in need.
