Carney, Roskam Celebrate Introduction Of Ways And Means Medicare Fraud Bill

Press Release

Today, Congressman John Carney (D-DE) and Congressman Peter Roskam (R-IL) and praised introduction of the Protecting Integrity in Medicare Act of 2014 (PIMA), a Ways and Means Committee bill aimed at combating waste, fraud, and abuse in Medicare. PIMA, which was first released as a discussion draft this summer, includes the Roskam-Carney Preventing and Reducing Improper Medicare and Medicaid Expenditures (PRIME) Act of 2013. Senator Tom Carper (D-DE) authored the Senate companion to this bill.

"The PRIME Act will strengthen Medicare and protect seniors by ensuring that resources go to those who need them, not criminals looking to take advantage of the system," said Congressman Carney. "In this Congress, it's not easy to find areas where Democrats and Republicans agree, but fighting waste, fraud, and abuse while saving billions of taxpayer dollars just makes sense. It's very encouraging that the Ways and Means Committee included our bill in their efforts."

"Medicare and Medicaid are vital programs that millions of our nation's seniors rely on, and yet criminals and bureaucratic negligence rob these programs of as much as $60 billion a year," said Congressman Roskam. "Strengthening and preserving Medicare for future generations means using 21st century technology, information sharing, and common sense solutions to stop fraudsters in their tracks. I'm pleased that solutions I've long fought for in the bipartisan and bicameral PRIME Act have been taken up by the Ways and Means Committee and included in their Medicare fraud package and look forward to swift action through the House."

Highlights of the PRIME Act in the Ways and Means Medicare Fraud Package include provisions:

* Phasing out the antiquated "Pay-and-Chase" system that pays out money even for suspicious Medicare claims. By better incentivizing Medicare Administrative Contractors (MACs), who are the first line of defense against fraudulent claims, we can save taxpayers billions of dollars

* Requiring that HHS enhance the Medicare-Medicaid, or Medi-Medi program in order to ensure federally run Medicare and state-run Medicaid share information on fraudsters, so if a provider or beneficiary is found to be abusing one system, they are also barred from the other

* Linking contract payments to accuracy goals for Medicare contractors and defines penalties for not meeting those goals -- ensuring processors have skin in the game and actively work to verify claims before sending taxpayer dollars out the door

* Building on the Senior Medicare Patrol program by requiring Medicare officials to improve outreach so more of our nation's seniors are aware of the fight against waste and fraud, and also expanding the program to include Medicaid beneficiaries

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