The HHS Office of the Inspector General (OIG) has identified a fraud scheme that could have a widespread and costly impact on Medicare and Medicaid payors and providers, according to a report released March 6.  
 
In these attempts, bad actors pretend to be hospital providers and submit fraudulent electronic funds transfer authorization requests to Medicare and Medicaid payors to divert payments away from providers. According to the OIG, two-thirds of surveyed payors noted that they were targeted in these schemes. Some reported that they received fraudulent electronic funds transfer requests on a frequent or recurring basis.  
 
When successful, these fraud schemes could lead to large financial losses. To combat these concerns, the OIG recommended that CMS work with Medicare Administrative Contractors (MACs) and share information with state Medicaid agencies to improve security measures. Officials also called for CMS to “support periodic information sharing” to shed light on these threats, though the report notes that CMS did not concur with this recommendation. 
 
To view the OIG’s electronic payment fraud scheme report, visit https://bit.ly/4iMb7IU.  
 
More coverage for HHL readers: