Senate Passes Bipartisan PRIME Act Provisions to Curb Medicare and Medicaid Waste and Fraud

WASHINGTON – Today, the Senate passed major provisions of the bipartisan Preventing and Reducing Improper Medicare and Medicaid Expenditures (PRIME) Act (S. 861) to improve program integrity within Medicare and Medicaid. The PRIME Act, which has 17 bipartisan cosponsors, was introduced by Sens. Tom Carper (D-Del.) and Mike Enzi (R-Wyo.).

 “Medicare and Medicaid provide access to quality healthcare to seniors, children and families across the country every day,” said Sen. Carper. “But each year, millions of dollars that should be going to our most vulnerable Americans are lost to waste and fraud. The common-sense measures within the PRIME Act are a win-win. They will help us fulfill our responsibility to make sure this vitally important program has the resources it needs, while working to make us better stewards of taxpayer dollars by reducing instances of waste, fraud, and abuse. I look forward to working with my colleagues in the House to get this legislation over the finish line and on to the President for his signature.”

 “We hear a lot about how Washington lacks common sense. People are usually right about that. This time, however, we’re using common sense,” said Sen. Enzi. “This bill does not affect coverage or benefits, but does make practical changes to the system. We’ve used Government Accountability Office, HHS Inspector General and other expert findings and recommendations to build in better efficiencies.”

 The provisions approved today will specify criminal penalties for fraudulently buying, selling or distributing Medicare and Medicaid patient information, specifically beneficiary identification numbers. The legislation will also facilitate information sharing between federally administered Medicare and state-administered Medicaid to prevent fraudulent activity in both programs, and incentivize accurate payments to Medicare providers in order to prevent improper payments.

 The PRIME Act provisions were included as part of a larger package of health care related legislation approved by the Senate by Unanimous Consent called the Patient Access and Medicare Protection Act (S.2425).

 In April, an additional set of waste and fraud prevention provisions from the PRIME Act, were included as part of the Medicare Access and CHIP Reauthorization Act that was signed into law in April.