Rep. Greg Walden, R-Ore. (Photo: Walden)
Members of the U.S. House voted Monday to pass a bill that could help private health insurers fight fraudulent claims.
The bill is H.R. 525, the “Strengthening the Health Care Fraud Prevention Task Force Act of 2019″ bill.
The bill calls for the secretary of the U.S. Department of Health and Human Services (HHS) to set up a public-private anti-fraud partnership program.
|Public-private partnership program details
The new partnership program would be open to federal health programs , state health programs, law enforcement agencies, private organizations that fight health care fraud, private health plans, and other entities.
The partnership program would create data-sharing and data-use agreements that would let the member organizations share confidential billing data.
The HHS secretary would then hire a “trusted third party” to help the member organizations share billing data.
The contractor would warn the member organizations about apparent vulnerabilities, report “specific cases of potential unlawful conduct” to law enforcement agencies, and look for possible signs of fraud, waste and abuse.
The HHS secretary would prepare a report on the partnership program's activities every two years.
The partnership program contractor would also prepare a separate analysis looking at any signs of worrisome billing patterns at substance use disorder treatment providers, according to the bill text.
|Legislation mechanics
Rep. Greg Walden, R-Ore., introduced H.R. 525.
The list of cosponsors includes another Republican, Rep. Kevin Brady of Texas.
The cosponsor list also includes two Democrats — Frank Pallone Jr. of New Jersey and Richard Neal of Massachusetts.
House leaders put H.R. 525 on their “suspension calendar,” or their list of noncontroversial items that can pass through the House quickly, without facing all of the rules that apply to ordinary measures.
Members of the House approved H.R. 525 by a voice vote. It's possible that some House members voted against the bill, but the House did not record the yeas and nays.
Senate Majority Leader Mitch McConnell has no obligation to bring H.R. 525 up on the Senate floor, but the fact that the bill has both a Republican sponsor and strong Democratic support may increase the odds of the bill getting passed in the Senate and signed into law.
|Resources
The official information page for H.R. 525 is available here.
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Allison Bell
Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.
