PASCRELL OUTRAGED OVER MEDICARE ADVANTAGE PROFITEERS
U.S. Rep. Bill Pascrell, Jr. (D-NJ-08) questioned the Centers for Medicare and Medicaid Services (CMS) Chief Financial Officer, Timothy Hill, during today's Ways and Means joint Oversight and Health subcommittee hearing on Medicare Advantage (MA) audits:
"I am outraged over the windfall profits being reaped by private insurance companies participating in the Medicare Advantage program. Working class families are experiencing increased premiums and decreased quality care. Seniors are completely confused by marketing abuses committed by MA brokers. Despite these conditions, CMS offered contracts to private insurers that included no authority for the federal government to pursue financial recovery audits. There is no accountability and no oversight. I am disappointed by the careless approach CMS has taken to administer Medicare Advantage and will pursue necessary adjustments to an abused program that is in need of dramatic repair."
According to GAO's assessment of the statutes, CMS had the authority to pursue financial recoveries, but its rights under contracts for 2001-2005 are limited because its implementing regulations did not require that each contract include provisions to inform organizations about the audits and about the steps that CMS would take to address identified deficiencies, including pursuit of financial recoveries.