Waltz Comments on Potential Issues Raised by Anti-Fraud Collaborations Between Government Agencies

Partner Judith Waltz is quoted in a Bloomberg BNA Health Law Resource Center article, “Veterans Affairs to Collaborate With HHS on Anti-Fraud Measures,” about an attempt to modernize the Department of Veteran’s Affairs fraud-fighting efforts by using the Centers for Medicare & Medicaid Services’ health care anti-fraud technology.

Waltz said the VA and the CMS must address any legal limits that may exist regarding the sharing of personal information between the two agencies. She cited the fact that the CMS and the Food and Drug Administration had to seek special permission to share data under the Sentinel initiative, which allows Medicare Part D claims data to be used for post-market research and makes the de-identified data available to the public.

“The amount of data that Medicare and the VA programs have available about health care claims is mind-bending and in theory should be very useful in the fight against fraud,” she said.

Waltz also said that VA programs already rely on some Medicare policies for coverage and reimbursement purposes, so it makes sense that the two programs would combine their efforts.