Last night, Congressman Peter Roskam (IL-06) was on FOX News' On the Record with Greta Van Susteren to talk about Illinois' Medicaid program that paid out $12 million in claims to dead people, and the national problem of Medicare fraud, waste and abuse. Roskam's PRIME Act would increase data sharing between Medicare and Medicaid and use modern technology to combat this massive waste of taxpayer dollars.
Serious Communication Problem Between Federally-Run Medicare and State-Run Medicaid
"This happens because the systems are so big and so inefficient that they are not talking with one another. So right now you have got Medicaid, what is literally paying out benefits to people who have passed away, which is an outrageous scandal. But it raises a larger problem, and that is, you've got states that are finding out information about people that shouldn't get benefits and they are not communicating that in any substantive way to these federal programs like Medicare. So you can have a state that discerns somebody shouldn't be able to get a particular benefit, but that information by and large isn't being shared back with the federal government."
PRIME Improves Data Sharing Between Programs
"[The PRIME Act] requires the Department of Health and Human Services to say look, "you've got to do this better. You've got to get it so the federal government and the state government are talking to one another.' Right now only 10 states who find out they have got fraudsters in their system report that information back to the federal government. And this is a massive problem. And it's been understated. Ten percent of Medicare -- or about $50+ billion a year -- is either paid out in false claims, fraudulent claims, or duplicative claims. But however you characterize it, it is a complete waste of money. And we have got the technology to deal with it right now."
PRIME Brings Outdated Medicare Fraud System into 21st Century
"It's part of a larger discussion to try to move forward and move these massive systems. So if you listen to the federal agencies, they'll wring their hands and say, "hey, we are doing our best and doing everything we can.' But the bottom line is -- they're not. This systems are in place. They're very, very old models. They're literally wasting billions of dollars. And, in a nutshell, we can do better and we've got to do better."