January 28,2010

Grassley fights fraud, waste and abuse in Medicare, Medicaid, CHIP

WASHINGTON – Senator Chuck Grassley today introduced a wide-ranging bill to fight fraud, waste and abuse in Medicare, Medicaid and the Children’s Health Insurance Program.

“This bill brings together common sense, bipartisan initiatives to fight fraud, waste and abuse in taxpayer-sponsored health care programs, which all face serious budgetary challenges,” Grassley said. “As spending on these programs continues to grow, Congress should act quickly to pass these reforms out of respect for taxpayers and on behalf of program beneficiaries.”

Grassley said his bill includes provisions that would:

• deter fraud with enhanced screening to improve the government’s ability to keep fraudulent providers from participating in these programs from the start;

• limit tax dollars lost to fraud by giving the government more time to evaluate the legitimacy of Medicare providers before payment is required when fraud, waste and abuse is suspected that is allowed under the existing pay-and-chase model;

• strengthen the government’s ability to detect fraud with better disclosure requirements;

• enhance coordination among federal agencies responsible for fighting fraud, including sharing data sources; and,

•improve enforcement capabilities by expanding the range of activity subject to penalties and toughening existing penalties.

Grassley said the “Strengthening Program Integrity and Accountability in Health Care Act” is comprised of reforms with bipartisan support. Grassley led the development of a number of these provisions during the bipartisan work in the Senate last year on comprehensive health care legislation. The Medicare payment reform measure also was introduced by Grassley in November (S.2774).

In addition, today’s bill includes portions of bipartisan legislation Grassley introduced nearly a year ago (S.458) to fortify the Federal False Claims Act. The measures are a response to federal court decisions that have limited the scope and applicability of the FCA. They would restore the original Congressional intent of the highly effective updates to the FCA in 1986. Grassley was the principal Senate author of those whistleblower updates to the law that has recovered more than $22 billion for the U.S. Treasury that otherwise would have been lost to fraud. The law has become the government’s most effective tool against health care fraud.