Obamacare may curb health care spending, lead to more investigations

March 05, 2013 (Press-News.org) Obamacare may curb health care spending, lead to more investigations

Article provided by Rivas Goldstein LLP
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A new government report states the massive increases in health care costs are starting to slow. In fact, according to Susan Dentzer, an expert with the well respected journal Health Affairs, 2009 and 2010 showed the slowest increase in health care spending in 51 years.

The motivator for this change is a controversial topic in Washington. According to some, the change is due to the economic downtown. People simply can't afford to spend as much on health care as they once could. According to others, the change shows the many tools provided within Obamacare to cut costs are working.

One tool used by Obamacare to cut the overall cost of health care is an increase in health care investigations to find and stop fraudulent Medicare and Medicaid claims.

Details of CBO's report

The Congressional Budget Office (CBO) released a report supporting those who argue the overall cost of health care is down because Obamacare is working. According to this group, the Patient Protection and Affordable Care Act, also known as Obamacare, is playing a significant role in curbing health care costs across the nation.

In 2010, health care costs went up 3.9 percent. Although this shows the cost of health care is still on the rise, it is much less than it was previous years. For example, 1990 saw a jump of 11 percent.

The CBO argues that this change makes sense. According to the new law, most of the population has health insurance. As a result, the overall cost of health care decreases because people are now more likely to take advantage of preventative measures. This means patients can receive care in the early stages of a cold, instead of waiting until it becomes so severe it develops into pneumonia and requires hospitalization.

What this means for health care investigations

One of the goals of the Affordable Care Act is to fight waste, fraud and abuse. One way the law aims to fight fraud and abuse is by expanding the use of Recovery Audit Contractor program. The audits conducted by this group will focus on finding "bad actors."

Unfortunately, the audit may wrongly accuse an innocent provider. Those accused of fraud are often subject to on-site visits, probation and criminal background checks.

Although putting an end to fraud is important, critics are concerned some investigations may go too far. Reuters reports, for example, that one of the largest for-profit hospitals, HCA Holdings Inc, was recently investigated by federal officers to determine if heart procedures were medically necessary.

Whether an investigation is just beginning or you are already fighting criminal charges, it is important to seek the counsel of an experienced health care fraud attorney to discuss your situation and better ensure your legal rights are protected.