By-Lined Article
New Weapons against Fraud and Abuse Under The Affordable Care Act
By Joanne B. Erde and Harry R. Silver
Midyear 2012
South Florida Legal Guide
The individual mandate and the other insurance-related provisions contained in the Affordable Care Act (ACA) have drawn most, if not all, of the public attention. Virtually unnoticed, except by those in the industry, are the significant fraud fighting weapons that the ACA has added to the government’s arsenal. These ACA provisions are not under review in the challenges to the act currently before the U.S. Supreme Court. If, however, the entire statute is struck down, it is safe to say that both Republicans and Democrats will be very upset because much of the money that was appropriated by the ACA to implement anti-fraud efforts has already been spent. More significantly, these ACA provisions are clear money-makers for the government. Should this baby be thrown out with the bathwater of the individual mandate, the government will be deprived of significant fraud fighting tools, as well as a substantial revenue stream.
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