December 17,2009

Grassley works to identify Medicare fraud, waste and abuse

WASHINGTON --- Senator Chuck Grassley is asking top officials why the federal government is failing to deliver an annual assessment of the level of improper Medicare payments for the second year in a row.
In a letter sent today to the Secretary of Health and Human Services and the Acting Administrator for the Centers for Medicare and Medicaid Services, Grassley asked for an accounting of what the agency has done to address the controversies in the methodology used by the contractor, which reportedly kept last year’s report from being made.

“Medicare is a massive entitlement program that spends hundreds of billions of tax dollars every year, yet this is the second year without an authoritative audit that provides a breakdown of payment error rates by provider type,” Grassley said. “Without this kind of assessment, administrators and policymakers aren’t galvanized, as they ought to be, to do everything possible to better safeguard program dollars for beneficiaries and taxpayers. This is especially problematic in light of the impending insolvency of Medicare. Whatever the reason for the agency’s inability to provide the data, the result is ineffective management of scarce Medicare dollars.”

Grassley previously questioned the Centers for Medicare and Medicaid Services regarding allegations that it hadn’t incorporated necessary data when calculating the improper payment rate for durable medical equipment. This impacted the work of the contractor carrying out the Comprehensive Error Rate Testing program, or CERT, designed to identify improper Medicare payments.

The text of Grassley’s letter today, his inquiry from May 2008, and additional background information is attached.