Sen. Chuck Grassley of Iowa today joined a bipartisan effort to solicit ideas from health care practitioners and others with firsthand knowledge of ways to fight Medicare and Medicaid fraud.
"Every dollar that goes to waste, fraud or abuse doesn't help a Medicare or Medicaid beneficiary," Grassley said. "The practitioners in the field who know how the system works should have the chance to weigh in with their tips and proposals. Congress needs to hear from these individuals directly and have an open discussion about things we haven't tried or considered. The expertise of those who work in health care every day can go a long way toward preserving tax dollars for these programs and the many people who rely on them."
Grassley joined the chairman and ranking member of the Finance Committee, along with three other committee members, in inviting interested stakeholders to submit white papers offering recommendations and innovative solutions to improve program integrity efforts, strengthen payment reforms, and enhance fraud and abuse enforcement efforts. Submissions are due by June 29, 2012. A summary document highlighting key proposals will be compiled and released later this year.
In addition to the anti-fraud work of the Government Accountability Office, agency inspectors general, and congressional legislation, the senators want to provide a venue to those who might not have a clear vehicle for presenting their ideas under current options.
In their open letter to health care experts, the senators wrote, "We believe federal efforts would be strengthened by input from members across the health care community -- providers, payers, health plans, contractors, non-profit entities, consumers, data analytics entities, governmental partners, and patients. Drawing on the collective wisdom and accumulated insights of thousands of professionals and individual experiences could offer a fresh perspective and potentially identify solutions that may have been overlooked or underutilized."
In addition to Grassley, the members of the Senate Finance Committee who wrote the letter are Ranking Member Orrin Hatch (R-Utah), Chairman Max Baucus (D-Mont.), and Sens. Tom Coburn (R-Okla.), Ron Wyden (D-Ore.), and Tom Carper (D-Del.).
The Finance Committee has jurisdiction over the Medicare and Medicaid programs.
Grassley is former chairman and ranking member of the Finance Committee, where he continues to serve as a senior member.
Grassley is the sponsor of the pending Program Integrity and Accountability in Health Care Act of 2011, which includes anti-fraud reforms with bipartisan support. The measure includes limiting tax dollars lost to fraud by enhancing coordination among federal agencies responsible for fighting medical identity theft, in which thieves use personal and health insurance information to bill for medical treatment and prescription drugs fraudulently; stopping payments for illegal, unapproved drugs; and requiring Medicare claims and payment data to be available to the public by provider name for the first time, similar to other federal spending disclosed on http://USAspending.gov.
Grassley is the Senate author of the 1986 whistleblower updates to the federal False Claims Act. Since 1986, the whistleblower provisions have recovered more than $30 billion that otherwise would have been lost to fraud and deterred many additional billions of dollars in fraud. The law has become the government's most effective tool for fighting health care fraud.