Roskam & Kinzinger Tout Bill to Cut Medicare Fraud

Press Release

Lawmaker highlight legislation that could save billions annually

Suburban Illinois Congressman Peter Roskam joined Republican congressional candidate Adam Kinzinger today to highlight his legislation that will reduce Medicare fraud by implementing cutting-edge technology to root out fraudulent healthcare transactions that cost taxpayers billions of dollars every year. Roskam's legislation, the Fighting Fraud with Innovative Technology Act, would establish a comprehensive pre-payment review system using complex algorithms to "flag" suspicious claims, similar to systems currently used by credit card companies.

"In America today, when the national debt is large enough to hold back an economic recovery, we should be eliminating every wasted penny in every corner of the budget," said Cong. Roskam, a member of the House Ways & Means Committee. "Medicare fraud is estimated to cost taxpayers up to $60 billion annually, robbing funding from a Medicare system that is already strained. Our solution is one that the credit card industry has used successfully for years: predictive modeling technology that recognizes atypical behavior and stops fraudulent payments before they happen. With over $13 trillion in debt, we need to embrace this type of technology to reduce fraud, waste and abuse and save some of the taxpayers' money."

"I applaud Cong. Roskam for this innovative solution to combat a very expensive problem," said Republican candidate Adam Kinzinger. "Unfortunately, the government healthcare overhaul did not do enough to embrace common-sense solutions like this proposal. Perhaps if Nancy Pelosi and the Democrat Congress had listened to their constituents, as well as their Republican colleagues, more smart solutions like Congressman Roskam's idea would have been included. I look forward to helping Cong. Roskam pursue passage of this legislation and working toward other innovative solutions to our nation's challenges."

Rep. Roskam's legislation would save taxpayer dollars by utilizing the same proven technologies that credit card companies use to prevent improper payments.It is estimated that nearly 10 percent of all federal healthcare payments, roughly $60 billion, are lost each year as a result of waste, fraud and abuse. The legislation would replace the current "pay and chase" system, in which fraudulent providers are paid first and only investigated later with a pre-payment review fraud prevention system that would use analytics and other technology to "flag" potentially fraudulent claims before the money is reimbursed.

The National Health Care Anti-Fraud Association wrote, "(p)ut simply, stopping a fraudulent dollar before it goes out the door is inherently more efficient than trying to recoup that dollar after it has been paid." (NHCAA letter, 6/15/10) The credit card industry processes $11 trillion every year, yet only 0.047% of the transactions are fraudulent. While Medicare is 25 times smaller than the credit card industry, it suffers 12 times more fraud. The Fighting Fraud with Innovative Technology Act (H.R. 5546), is a bi-partisan bill supported by the White House and backed by AARP, Citizens Against Government Waste, the National

Healthcare Anti-fraud Association and the American Association for Homecare.

Last month, as part of his "Pathways to Prosperity" Agenda, Kinzinger included his "Pathway to Keeping Promises", stating:

I will vote to ensure that the federal government keeps the promises it has made to seniors and those who have paid into Social Security and Medicare. I will further work to prevent the certain financial collapse of those programs by promoting bipartisan efforts to address structural problems and ensure its longevity for future generations.

The Fighting Fraud with Innovative Technology Act is a policy that will ensure that Congress keeps its promises, as Kinzinger has pledged to do in his "Pathways to Prosperity" Agenda.

"These are the type of practical solutions that can help our nation address the problems with our healthcare system," continued Roskam. "I look forward to working with Adam Kinzinger next year as a member of a Republican majority that advances common-sense legislation such as this to curb waste and fraud in our government."

"I thank Cong. Roskam for his willingness to travel to the 11th District to highlight this exciting proposal to reduce waste," said Kinzinger. "It represents the type of innovative proposal that all parties should be able to rally around, but the current majority has seemingly been unwilling to advance. The next Congress will be an opportunity to bring this type of legislation forward to achieve bi-partisan successes for all Americans."

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