Sen. Carper Highlights HHS IG Report Finding Repeated Failures to Oversee Medicare Contractors Charged with Fighting Fraud

WASHINGTON – Today, Sen. Tom Carper (D-Del.) highlighted a report by the U.S. Department of Health and Human Services Inspector General (IG) that found repeated failures in supervision and oversight of contractors hired to detect fraudulent claims in Medicare. The contractors are paid millions in taxpayer dollars annually as part of an effort to stop an estimated $60 billion a year in improper payments. The IG report found that the data used by the Centers for Medicare and Medicaid Services (CMS) to oversee the contractors – known as Zone Program Integrity Contractors (ZPIC) – was not accurate or uniform, undermining the ability of the contractors to effectively safeguard billions of taxpayer dollars spent by Medicare.

These findings underscore the need for robust legislation to curb waste and fraud in Medicare and Medicaid, such as bipartisan legislation co-authored by Sen. Carper and Sen. Tom Coburn (R-OK) , the Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayer Dollars Act (FAST Act, S.1251). The FAST Act would require Medicare officials to share data on waste and fraud with law enforcement agencies, state agencies and contractors and to establish a more accurate payment system for Medicare claims.

“You can’t manage what you can’t measure,” said Sen. Carper. “For years, Medicare officials have failed to adequately measure – let alone manage – the oversight contractors hired to curb waste and fraud from the billions of taxpayer dollars they spend annually on health care for our nation’s seniors. Over the years, we’ve heard promise after promise that the next great tool for tracking these payments is just around corner, but the Inspector General report shows clearly that real progress always requires basic contractor oversight and management. That’s why I’ve teamed up with Sen. Coburn and others to introduce the Fighting Fraud and Abuse to Save Taxpayer Dollars Act (FAST Act), bipartisan legislation that takes a number of basic but critical steps – including making sure that Medicare officials share fraud data with law enforcement and the people performing oversight, as well as putting accuracy requirements into the payment administration contracts.”

Sen. Carper’s legislation, 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; and

• deploy cutting-edge technology to better identify and prevent fraud.

Please click here to read the full IG report.

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