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House Ways & Means, Senate Finance Committee Members Question Whether CMS is Fully Protecting Medicare from Waste, Fraud & Abuse

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Date:
Location: Washington, DC

In a letter today, House Ways and Means Health Subcommittee Chairman Wally Herger (R-CA) and Oversight Subcommittee Chairman Charles Boustany, M.D. (R-LA), along with Senate Finance Committee Ranking Member Orrin Hatch (R-UT), and Committee member Tom Coburn (R-OK), asked the Acting Administrator of the Centers for Medicare & Medicaid Services (CMS), Marilyn Tavenner, whether the agency is fully utilizing its resources to safeguard the Medicare program from waste, fraud and abuse.

Specifically, the lawmakers requested information regarding the agency's efforts to identify "nominee owners" and the type of fraud perpetrated by individuals and organizations establishing false storefronts and "shell companies" -- paper-only firms with no real operations.

"On March 7, 2012, the Department of Justice (DOJ) indicted an individual for allegedly swindling $20 million from the Medicare program over a five-year period by establishing two home health agencies using a nominee owner," wrote the lawmakers. "This indictment, along with the other examples cited in this letter, demonstrate that CMS's provider screening efforts are still not effectively safeguarding the Medicare program from individuals intent on committing fraud within the Medicare program and that CMS should revise its screening efforts to address nominee owners."

The House Ways and Means and Senate Finance Committees have jurisdiction over the Medicare program.


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