07/22/2026
Medicare fraud is the type of stubborn problem that takes on many different shapes and sizes. Today, our Co-Founder and Chief Medical Officer, Dr. Amer Alnajar, participated in a roundtable discussion before the Health Care and Financial Services subcommittee on skin substitute fraud which, alone, grew from $200M to $14.4B in just six years.
ACOs play a pivotal role in improving patient care and fighting Medicare fraud since ACOs have both the data and patient and provider relationships to identify suspicious billing patterns and report them to CMS. To that end, Vytalize has proposed strengthening the ACO fraud-fighting role by allowing qualified ACOs to trigger prepayment review of potentially fraudulent claims, stopping improper payments before taxpayer dollars leave CMS.
This is what it means to be accountable for the cost and quality of patient care.
Many thanks to Subcommittee Chairman Glenn Grothman for the humbling opportunity to offer our input as Vytalize, and a well-deserved shoutout to Accountable for Health and CEO Mara McDermott for their continued leadership on this issue and for amplifying the ACO community’s voice in Washington.
Vytalize and the broader ACO community are excited to work with Congress and CMS to protect both patients and taxpayers, and we look forward to working with Dr. Oz to deliver even greater value. Learn more from the link in our bio.