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February 20, 2017 at 02:45 AM
Last week, President Donald Trump named Rene Alexander Acosta to be his new Labor secretary pick.
Some benefits lawyers glanced at Acosta’s biography and assumed that he must not know much about health insurance.
Acosta has a bachelor’s degree and a law degree from Harvard.
He served as a member of the National Labor Relations Board from 2002 to 2003; as the assistant attorney general for civil rights at the U.S. Department of Justice from 2003 to mid-2005; and as the U.S. attorney for the Southern District of Florida from mid-2005 to mid-2009.
Since 2009, he’s been the dean of the Florida International University law school.
Trump nominated Acosta to be his Labor secretary after Andrew Puzder, a California fast-food chain executive, withdrew his name from consideration.
Related: Puzder withdraws as Trump’s Labor nominee amid Republican doubts
Many news organizations have covered Acosta as if he is just a mild-mannered law school faculty member who apparently knows something about Americans with Disabilities Act compliance.
In reality, from 2005 through 2009, while Acosta was the U.S. attorney for the Southern District of Florida — the top federal prosecutor for the region that includes Miami, and all of the federal crime that occurs in Florida from Key West up past West Palm Beach — he started the country’s first health care fraud task force.
While Acosta was managing the effort to prosecute Jack Abramoff for fraud and major cocaine importers for importing cocaine, he was also leading an effort to charge about 700 people with $2 billion in health care fraud, or about $1,900 in fraud per Medicare enrollee in South Florida.
Related: Medicare fraud attracts gangsters
Acosta testified in 2011 at a House Energy and Commerce oversight subcommittee hearing that, in 2008, his district accounted for 32 percent of the country’s health care fraud investigations.
Knowledge of health care claim fraud could be useful to a Labor secretary, because the U.S. Department of Labor is the parent of the Employee Benefits Security Administration. EBSA oversees group health benefits and other employee benefits, such as group disability insurance. Acosta may not be a specialist in the Employee Retirement Income Security Act, but he knows plenty about something that may be even more important to the plan sponsors, administrators and insurers: minimizing waste, fraud and abuse.
Here’s a look at some of what Acosta knows and has said about fraud against Medicare, Medicaid and private health insurance programs, based mainly on testimony from a 2011 House hearing and from testimony at a 2008 hearing on Medicare and Medicaid fraud organized by the Senate Special Committee on Aging.
In 2003, Acosta faced Ted Kennedy, Orrin Hatch, Jeff Sessions and other senators at a nomination hearing for a Justice Department post in the George W. Bush administration.
1. Hearings
To become Labor secretary, Acosta needs to get a majority vote in the Senate, at a time when Democrats are facing intense pressure from constituents to vote against all Trump nominees, and a few Republican senators are crossing party lines to vote against some nominees.
Acosta has already gone through Senate confirmation processes to serve on the National Labor Relations Board, to become the assistant attorney general for civil rights, and to become the U.S. attorney for South Florida.
In 2003, when Acosta was on his way to becoming the assistant attorney general for civil rights, the members of the Senate Judiciary Committee panel that reviewed his nomination included Orrin Hatch of Utah, who is still serving in the Senate, and the late Ted Kennedy. Another member of the panel was Jeff Sessions of Alabama, who just been confirmed as Trump’s attorney general.
Sessions asked Acosta about ways to protect voters’ rights while speeding up the Voting Rights Act claim review process.
Related: 3 ways the big life app checker bureau could grow
Acosta’s health care fraud fighters fought hard to get access to unidentified Medicare claim data. (Image: NASA)
2. Claim data
Acosta testified at the 2011 Medicare and Medicaid hearing that the South Florida health care anti-fraud office was as productive as it was because it had persuaded Medicare program managers to provide access to Medicare claim data, with the patient names stripped out.
The office hired a nurse practitioner to go through the data and look for billing spikes.
Related: Dealing with the Data
Acosta has been a major advocate for increased use of predictive analytics in health care anti-fraud efforts. (Image: Thinkstock)
3. Math
Acosta testified at the 2011 hearing that health care fraud investigators need predictive analytics tools, or statistical data, to look for unusual billing patterns.
