Cumberland Times-News

July 17, 2013


Act aims to cut fraud in Medicaid, Medicare

Cumberland Times-News

— We’d like to think that the PRIME Act — short for Preventing and Reducing Improper Medicare and Medicaid Expenditures — will be a slam dunk for passage in Congress.

The legislation is a bi-partisan effort to crack down on fraud. Its sponsors believe it can save billions of dollars in Medicare and Medicaid spending.

Essentially, PRIME would result in:

• Penalizing bill-paying companies that make errors and overpay Medicare service providers.

• Encouraging older Americans to join the fight against fraud, with better rewards for tips that lead to recovery

• Making it harder for criminals to steal the identities of physicians so they can submit fraudulent claims.

• Stiffening penalties for stealing seniors’ identities.

Sen. Tom Coburn (Okla.), the top Republican on the Senate Homeland Security and Government Affairs Committee, said the bill reflects the recommendations of many health experts, and is needed to ensure Medicare and Medicaid spending goes to the people who need healthcare access. “Americans who rely on Medicare and Medicaid expect Congress to work together to reduce waste and fraud,” Coburn said. “Improper payments divert scarce resources away from those most in need.”

The legislation would take several other  steps to stop wasteful Medicare and Medicaid spending, including a new effort by the Center for Medicare and Medicaid Services to ensure people don’t steal the identities of deceased doctors and use them to claim reimbursements from the government. The bill also requires Medicare officials to talk more with Medicare beneficiaries to help them spot waste and fraud, including by showing them how to review their Medicare statements for inaccuracies.    

The Senate bill is S. 1123, and is supported by Sens. Michael Bennet (D-Colo.), Chris Coons (D-Del.), Amy Klobuchar (D-Minn.), Mary Landrieu (D-La.), Claire McCaskill (D-Mo.) and Mark Warner (D-Va.). The House bill is H.R. 2305, and is backed by Reps. Ron Barber (D-Ariz.), Randy Hultgren (R-Ill.), Tom Reed (R-N.Y.) and Kurt Schrader (D-Ore.).

The bipartisan sponsorship of the legislation should greatly increase its chances of eventual enactment into law.