A press release from Congressman Peter Roskam:

Roskam, Carney Praise Committee Passage of
Bipartisan Medicare Fraud Package

Legislation Includes Roskam-Carney Bipartisan, Bicameral PRIME Act

WASHINGTON, DC—Today, Congressman Peter Roskam (R-IL) and Congressman John Carney (D-DE) released the following statements after the Ways and Means Health Subcommittee’s markup and subsequent passage of the Protecting Integrity of Medicare Act (PIMA), a bipartisan Medicare fraud package that includes the Roskam-Carney Preventing and Reducing Improper Medicare and Medicaid Expenditures (PRIME) Act of 2015.

Peter Roskam

“Every year that passes without addressing rampant Medicare fraud costs taxpayers billions and depletes the quality of this critical program for the American seniors who depend upon it for their healthcare,” said Congressman Roskam.

“I’m proud that key provisions of my PRIME Act are included in this bipartisan package to root out deficiencies that leave Medicare vulnerable to scams and fraud.

“These commonsense reforms are necessary to ensure Medicare dollars can go to providing important health services, not lining the pockets of crooks.

“Congressman Carney has been a tremendous partner in the effort to develop these thoughtful reforms, and I want to thank him for his leadership on this issue and commitment to making government work better for the American people.”

“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.”

“On behalf of the nearly 38 million AARP members and the millions of Americans with Medicare, we applaud the introduction and markup of the Protecting the Integrity of Medicare Act of 2015 (PIMA),” said AARP Senior Vice President Joyce Rogers.

“This important, bipartisan legislation, which includes sections of the PRIME Act AARP endorses, would positively impact older Americans by curbing waste, fraud and abuse in the Medicare program. AARP is committed to improving the efficiency and cost-effectiveness of our nation’s health care system, including Medicare, and we share this bill’s intent to do so.”

“PIMA, which includes provisions of the NCHC-endorsed PRIME Act, provides the tools necessary to fight the $60 billion in fraud and abuse that impacts Medicare beneficiaries every year,” said National Coalition on Health Care (NCHC) President and CEO John Rother. “We’ll need bipartisan legislative efforts like this if we are going to face up to the rising cost of health care.”

“AMAC is pleased to see a strong showing of bipartisan support for a resource critical to older Americans – Medicare. The passage of the ‘Protecting Integrity in Medicare Act (PIMA),’ and the inclusion of provisions of the ‘PRIME Act,’ is an important, positive step in strengthening Medicare for both current and future beneficiaries,” said Association of Mature American Citizens (AMAC) President Dan Weber.

“As a result of rampant waste, fraud and abuse in Medicare, seniors have unnecessarily suffered at the hand of administrative carelessness and criminals taking advantage of the system. PIMA rightly addresses these concerns and will work to phase out the broken ‘Pay and Chase’ system. The simple, commonsense fixes set forth in PIMA will not only put Medicare on a more stable fiscal path, but they will go a long way in protecting this important benefit for rightful beneficiaries and will save taxpayers billions of dollars.

“Taxpayers will be encouraged to see the many vital oversight provisions of the Protecting Integrity in Medicare Act (PIMA) pass through committee with bipartisan support,” said National Taxpayers Union (NTU) President Pete Sepp. “The legislation includes the critical taxpayer protections against Medicare waste of the PRIME Act. Over time, these no-brainer measures will help prevent costly improper payments through better data management. While further reforms are still needed to ensure the long-term fiscal health and sustainability of Medicare, the House should swiftly approve the measure to improve the stewardship of this troubled program.”

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

• Phasing out the antiquated “Pay-and-Chase” system that pays out even 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.