New rules take aim at Medicare fraud

The behemoth Medicare bureaucracy will have to act more like a credit card company in flagging suspicious bills under a new federal law that could save taxpayers billions of dollars a year in wasteful government healthcare spending.

The anti-fraud provision, tucked into the Small Business Lending Act that became law Monday, would force Medicare to end its 45-year-old policy of paying claims quickly without verifying them.

That antiquated billing system, designed to keep the wheels of public healthcare spending going full speed, has led to an estimated $60 billion-plus a year in Medicare fraud -- with South Florida recognized as ground zero.

The Centers for Medicare and Medicaid Services, which pays out $500 billion yearly for elderly and disabled Americans, would have to adopt new billing software with ``predictive modeling'' by next year. Such analytical technology enables the credit card industry to detect questionable bills for, say, a flat-screen TV purchased outside a cardholder's immediate area so that companies can notify the customer and stop payment if fraud is a factor.

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