GAO Releases Report on Medicare Anti-Waste and Fraud Spending

WASHINGTON – Today, Sen. Carper (D-Del.), Chairman of the Subcommittee on Federal Financial Management, commended Medicare officials’ improved efforts to allocate resources to fight waste and fraud in Medicare.

A report released today by the Government Accountability Office (GAO), requested by Sens. Carper, John McCain (R-Ariz.) and Scott Brown (R-Mass.), assessed how well the Centers for Medicare and Medicaid Services (CMS) allocates budgetary resources to fight fraud and waste in Medicare. In the past, CMS would allocate resources primarily based on the budget of the previous year, without adequate attention to new priorities or without developing improper payment problems. The report, “Medicare Integrity Program: CMS Used Increased Funding for New Activities But Could Improve Measurement of Program Effectiveness” (GAO-11-592) found that CMS has improved its budgeting for program integrity by factoring in the program’s priorities and performance goals.

“I am encouraged that the Centers for Medicare and Medicaid Services has greatly improved in its efforts to get better results for less money by targeting their program integrity dollars to more effectively fight waste and fraud,” said Sen. Carper. “But while Medicare officials are making strides in that fight, they still have a long way to go. Things are better, but not perfect. Curbing waste and fraud, including the tens of billions of dollars in Medicare improper payments, is a big job and we need the right tools in place to make progress. Moreover, government must embrace a culture of thrift where we look into every nook and cranny for savings without sacrificing results. The Centers for Medicare and Medicaid Services is on that path and it should continue to improve on its efforts.”

“While I’m encouraged that CMS has allocated its resources to expand Medicare Integrity Programs, there is still more work to be done to curb wasted taxpayer dollars in Medicare and Medicaid,” said Sen. Brown. “I look forward to working with CMS to ensure all MIP activities are fully developed, implemented efficiently and effectively and meet the improper payment performance goals.”

“I am pleased that the report I requested along with Senators Carper and Brown found that the Centers for Medicare and Medicaid Services is better targeting its funds for program integrity,” said Sen. McCain. “However, with unacceptably large amounts of money being lost to fraud and over $45 billion in improper payments, management of the Medicare program must be improved to protect taxpayers against waste, fraud and abuse.”

Sen. Carper’s Subcommittee on Federal Financial Management has held numerous hearings on the topic of curbing waste, fraud and abuse in Medicare. In June, Sens. Carper and Tom Coburn (R-Okla.), in addition to a bipartisan group of senators, introduced the Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayer Dollars Act (S.1251. The legislation, also known as the “FAST Act,” would address a set of problems that leads to tens of billions of dollars lost to waste and fraud in Medicare and Medicaid every year. Among its provisions, the FAST Act would:

• Enact stronger penalties for Medicare fraud;
• Curb improper payments and establish stronger fraud and waste prevention strategies to help phase out the practice of “pay and chase”;
• Curb the theft of physician identities;
• Expand the fraud identification and reporting work of the Senior Medicare Patrol;
• Improve the sharing of fraud data across federal and state agencies and programs;
• Deploy cutting-edge technology to better identify and prevent fraud

The GAO report can be found here: http://www.gao.gov/products/GAO-11-592

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