WEST CHICAGO - Congressman Peter Roskam (R-IL) and Congressman John Carney (D-DE) are lauding the inclusion of H.R. 2305, their bipartisan Preventing and Reducing Improper Medicare and Medicaid Expenditures (PRIME) Act of 2013, in the Ways and Means Medicare fraud discussion draft entitled The Protecting Integrity in Medicare Act of 2014 (PIMA).
“I am pleased to see our bipartisan, common-sense PRIME Act included in the Ways and Means Medicare fraud discussion draft,” said Congressman Roskam. “Medicare fraud is an urgent problem – we cannot continue to allow programs that so many of our seniors rely upon to be fleeced because of carelessness or criminals gaming the system. By combining 21st century technology, information sharing and good-government solutions, the PRIME Act and the forthcoming Ways and Means Medicare fraud bill will help stop fraudsters in their tracks and make Medicare and Medicaid more financially stable for the long term.”
“The PRIME Act will strengthen Medicare and protect seniors by ensuring that resources go to those who need it, not criminals looking to take advantage of the system,” said Congressman Carney. “It’s not easy to find areas where Democrats and Republicans agree, but fighting waste, fraud, and abuse while saving billions of taxpayer dollars just makes sense. I’m encouraged that the Ways and Means Committee included the bill in their efforts, and hopeful that this helps protect Medicare as a resource for seniors.”
Highlights of the PRIME Act in the Ways and Means Medicare Fraud Package include:
- Phasing out the antiquated “Pay-and-Chase” system that pays out even suspicious Medicare claims. By better incentivizing Medicare Administrative Contractors (MACs), who are the first line of defense against fraudulent claims we can save , taxpayers billions of dollars
- Demanding HHS enhance the Medicare-Medicaid, or Medi-Medi program in order to ensure federally-run Medicare and state-run Medicaid share information on fraudsters, so if a provider or beneficiary is found to be abusing one system, they are also barred from the other.
- Links contract payments to accuracy goals for Medicare contractors and defines penalties for not meeting those goals, ensuring processors have skin in the game and actively work to verify claims before sending taxpayer dollars out the door
- Building on the Senior Medicare Patrol program by requiring Medicare officials to improve outreach so more of our nation's seniors are aware of the fight against waste and fraud, and also expands the program to include Medicaid beneficiaries