Bipartisan Focus on Medicare Advantage Fraud Enforcement Intensifies

The Trump administration has prioritized enforcement against fraud and abuse in the Medicare Advantage (MA) program, with the U.S. Department of Justice investigating UnitedHealth Group's billing practices. Both the Trump and Biden administrations have identified fraud in the MA program as a key concern, focusing on large payers and providers. Despite past leniency shown by Trump towards individuals convicted of fraud, he has recently vowed to combat healthcare fraud, citing significant sums lost to fraudulent activities. This sentiment is echoed in efforts to reform policies around skin substitutes in Medicare, which have seen rampant exploitation, resulting in billions of dollars in waste. New Local Coverage Determinations will ensure that only clinically supported skin substitutes are covered, aiming to protect taxpayers and improve patient care. The overarching narrative suggests a bipartisan commitment to tackling healthcare fraud, albeit with varying approaches and historical contexts.