WASHINGTON, DC - Leaders of the House Energy and Commerce Committee, House Ways and Means Committee, and the Senate Finance Committee today sent a letter to Centers for Medicare and Medicaid Services (CMS) Acting Administrator Andrew Slavitt to express concerns about fraudulent Medicare spending despite the Agency’s recent efforts to prevent improper payments before they are sent out the door.
The letter was sent by House Energy and Commerce Chairman Fred Upton (R-MI), House Ways and Means Chairman Kevin Brady (R-TX), Senate Finance Chairman Orrin Hatch (R-UT), House Energy and Commerce Health Subcommittee Chairman Joseph Pitts (R-PA), House Energy and Commerce Oversight and Investigations Subcommittee Chairman Tim Murphy (R-PA), House Ways and Means Health Subcommittee Chairman Pat Tiberi (R-OH), and House Ways and Means Oversight Subcommittee Chairman Peter Roskam (R-IL).
Members explained that CMS still relies too heavily on the outdated “pay and chase" practice - paying a claim before investigating whether it was fraudulent. Expressing the need to end “pay and chase" and strengthen the Fraud Prevention System (FPS), the Members wrote:
“The billions of dollars lost to Medicare fraud each year underscore the importance of stopping potentially fraudulent payments before they are made. … Each dollar lost to fraud is a dollar that is not used to benefit patients. This represents a significant burden on the program and taxpayers."
The Members specifically requested for CMS to clarify the Agency’s implementation of the FPS program, including details on fraud investigations and how the Agency monitors FPS’s effectiveness.
