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Hearing of the House Subcommittee on Government Organization, Efficiency and Financial Management of the House Committee on Oversight and Government Reform - A Medicaid Fraud Victim Speaks Out: What's Not Working and Why?


Location: Washington, DC

Thank you, Mr. Chairman. I would also like to thank Mr. West for taking the time to come to Capitol H i ll to share his experience so we might apply the lessons learned f r om his case to future policy and law enforcement decisions.
Last year, Medicaid provided critical health care services to an estimated 56 million Americans in need, the vast majority of whom are seniors, individuals wi th disabilities, and children. Since so many Americans rely on this program, it is imperative that we root out fraud, because every dollar squandered is a dollar that does not go to critical health care services for these vulnerable Americans.

Today's hearing focuses on a case that was brought to light by Richard West, a Medicaid beneficiary who asserted his rights under the False Claims Act to prosecute fraud against the Medicaid system by Ma x im Healthcare Service. Mr. West's lawsuit retrieved nearly $150 million for the U.S. taxpayers. We need to support efforts by people like Mr. West to ensure that American citizens are empowered to take on corporate wrongdoing.

The written testimony of our witnesses on the second panel also makes clear that we needs better coordination between state Medicaid programs and the Centers for Medicare and Medicaid Services to reduce duplicative efforts and better align resources.

Fortunately, the Affordable Care Act provides additional funding to f ight waste, fraud, and abuse in Medicaid. It also contains a number of provisions designed to improve data quality and promote data sharing between federal agencies, the states, and health care providers.

The fight against unscrupulous companies like Maxim Healthcare Services requires more resources, not less. When we invest in fraud prevention, government spending more than pays for itself. That is one reason why repealing the Affordable Care Act and cutting Medicaid's enforcement budget would be shortsighted and counterproductive. I look forward to the testimony of our witnesses today and hope their recommendations will help reduce fraud, waste, and abuse and create a stronger Medicaid program for those who
rely on it.

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