WASHINGTON, DC - Bipartisan leaders of the House Energy and Commerce and House Ways and Means Committees today sent a letter to the Government Accountability Office (GAO) requesting a review of the Fraud Prevention System (FPS) at the Centers for Medicare and Medicaid Services. The FPS was implemented in July 2011 in an effort to more proactively prevent fraud in the Medicare program, as opposed to the “pay and chase" approach.
The leaders explain, “GAO has previously identified key practices for using predictive analysis systems, including leveraging the results of predictive analysis to address service- or system-specific weaknesses that can lead to payment errors, such as gaps in prepayment edits. It is unclear whether CMS is using FPS to identify these broader program vulnerabilities in Medicare and taking action based on these vulnerabilities throughout the program."
In addition to gaining a better understanding of how CMS is using the FPS in Medicare, the leaders are asking the nonpartisan government watchdog to review CMS’ plan to implement the program for Medicaid and the Children’s Health Insurance Program, as is directed under federal statute. The Energy and Commerce Subcommittee on Oversight and Investigations recently held a hearing to discuss a new report from the nonpartisan government watchdog, entitled “Additional Actions Needed to Help Improve Provider and Beneficiary Fraud Controls."
The letter was signed by:
Energy and Commerce Committee Chairman Fred Upton (R-MI)
Ways and Means Committee Chairman Paul Ryan (R-WI)
Energy and Commerce Subcommittee on Oversight and Investigations Chairman Tim Murphy (R-PA)
Ways and Means Subcommittee on Oversight Chairman Peter Roskam (R-IL)
Energy and Commerce Subcommittee on Health Chairman Joe Pitts (R-PA)
Ways and Means Subcommittee on Health Chairman Kevin Brady (R-TX)
Energy and Commerce Committee Ranking Member Frank Pallone, Jr. (D-NJ)
Ways and Means Committee Ranking Member Sander Levin (D-MI)
Energy and Commerce Subcommittee on Oversight and Investigations Ranking Member Diana DeGette (D-CO)
Ways and Means Subcommittee on Oversight Ranking Member John Lewis (D-GA)
Energy and Commerce Subcommittee on Health Ranking Member Gene Green (D-TX)
Ways and Means Subcommittee on Health Ranking Member Jim McDermott (D-WA)
Read the complete letter online HERE.
