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Grassley Seeks Answers on Key Anti-fraud Protections in Obamacare

November 7, 2013
Toledo Chronicle, Tama News-Herald

WASHINGTON Sen. Chuck Grassley of Iowa is seeking answers from the Obama administration on indications that Obamacare will bypass key anti-fraud protections.

"I am alarmed at indications that the Administration may try to exempt the Patient Protection and Affordable Care Act (PPACA) from certain federal anti-fraud provisions," Grassley wrote to top administration officials today. "PPACA provides for billions of dollars in subsidies to be paid directly to insurance companies. These taxpayer dollars should be subject to the full arsenal of civil and criminal anti-fraud protections provided by Congress."

Grassley's letter to Health and Human Services Secretary Kathleen Sebelius and Attorney General Eric Holder came amid statements that the administration does not consider qualified health plans and other programs related to the federally facilitated marketplace under the new health care law to be federal health care programs. That appears to mean the Obamacare programs are not subject to federal anti-kickback statutes and the federal False Claims Act, one of the government's most effective tools against fraud, especially health care fraud in recent years.

Article Photos

Sen. Chuck Grassley
R-Iowa

Grassley raised these concerns at a Finance Committee hearing with Sebelius on Wednesday. He asked her to explain her letter to a House member that the Obamacare health plans are not considered federal health care programs. She suggested Medicare Advantage, for example, and Obamacare should be treated differently for federal anti-fraud protections. Grassley believes both programs should be treated the same for anti-fraud purposes, since both involve direct payments from the government to private health care plans.

"Congress' intent to treat kickbacks under PPACA as False Claims Act violations is clear. It cannot lawfully be nullified by the stroke of a pen through an administrative exemption," Grassley wrote today. "If this nullification were allowed to stand, HHS would be removing a vital tool to investigate and prosecute fraud. It undermines public confidence that the government is serious about protecting American taxpayer dollars from fraud, waste and abuse. Intentionally attempting to strip away these vital protections by administrative fiat is extremely disturbing.

Grassley is the Senate author of the 1986 whistleblower amendments strengthening the federal False Claims Act, making it more effective than ever in exposing fraud against the government.

 
 

 

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