Statements on Introduced Bills and Joint Resolutions

Floor Speech

BREAK IN TRANSCRIPT

Ms. COLLINS. Mr. President, I am delighted to join my friend, the chairman of the Senate Committee on Aging, Senator Nelson, in introducing legislation to help combat fraud in the Medicare Program. We are introducing the Stop Schemes and Crimes Against Medicare and Seniors Act, or the Stop SCAMS Act.

As Senator Nelson has described, at our hearings earlier this year we heard absolutely appalling testimony from a woman who had to endure painful, 7-hour-long series of infusions for a disease she did not have just because her doctor was bilking the Medicare Program.

Imagine a physician who would do that, who would subject a vulnerable patient to the anxiety of thinking she had a disease she did not have and then treat her for a disease she did not have just to collect Medicare dollars. It really was appalling.

For decades the Government Accountability Office--GAO--has identified Medicare as being at high risk for improper payments, abuse, and fraud. In the year 2012 Medicare reported that it had lost more than $44 billion in improper payments due to waste, fraud, abuse, and mismanagement--and that estimate may well be too low. Think what we could do with $44 billion to improve the quality of health care and the coverage we are providing to our seniors or to reduce our unsustainable national debt. This is simply unacceptable.

The loss of these funds not only compromises the financial integrity and increases the costs of the Medicare Program, but it also undermines our ability to provide needed health care services to the more than 54 million older and disabled Americans who depend on this vital program.

Back in the late 1990s when I was chairman of the Permanent Subcommittee on Investigations, we held a series of hearings to examine fraud in the Medicare Program. We identified the dangerous trend of an increasing number of completely bogus providers entering the system with the sole and explicit purpose of robbing it. One of our witnesses actually testified that he went into Medicare fraud because it was easier and safer than dealing in drugs; he could make a lot more money at far less risk of being caught.

Our hearings led to the adoption of some safeguards and better internal controls. But many years later what our continuing hearings have demonstrated is that unscrupulous individuals are always adopting and seeking out new ways to rip off the system. They seem to be always one step ahead of the authorities.

I do wish to emphasize an extremely important point; that is, the vast majority of medical professionals are caring, dedicated health care providers whose top priority is the welfare of their patients.

When we were investigating Medicare fraud in the late 1990s, what we found were a whole lot of individuals posing as health care providers who had no medical training whatsoever. I remember one memorable case where, had there been a site visit, it would have been discovered that this bogus provider had an office in the middle of the runway of the Miami airport. But, unfortunately, back then there were no site visits.

Health care providers--the true professionals--are the ones who are most appalled by the unscrupulous bandits who take advantage of weaknesses in the Medicare Program to bleed billions of dollars from the program.

As I indicated, we have made some progress over the years in the battle against Medicare fraud since I chaired those hearings. Unfortunately, however, there is no line item in the budget titled ``waste, fraud, and abuse'' that we can simply strike to eliminate this problem and solve it once and for all.

The task of ferreting out wasteful and fraudulent spending is made all the more difficult by the ingenuity of the scam artists, who continually adopt new methods of ripping off both the Medicare and the Medicaid Programs.

It is clear, as my distinguished chairman indicated, that we must do more than shift from a pay-and-chase strategy to combat Medicare fraud to one that prevents the harm from ever occurring in the first place. That is what the bipartisan bill we are introducing today would do.

Among other provisions, our legislation would require Medicare to verify health care provider ownership interests using other databases before new health care providers are allowed to enroll in the program. That is an upfront control that we can and should implement. Currently, Medicare relies on self-reported information. As a consequence, providers who previously had an ownership interest in an organization that defrauded Medicare can potentially get back into the program by simply using different names and failing to disclose their interest in the previous organization or practice.

Our legislation would also allow private insurers to share information about potentially fraudulent providers with Medicare and with each other to prevent further health care fraud.

It would also allow the Medicare Payment Advisory Commission to make recommendations to us regarding fraud prevention, and our bill would require the Medicare Program to develop a strategy for more accurately and reliably estimating how many dollars are lost each year to fraud.

As the chairman indicated, our legislation is endorsed by a wide variety of organizations, including the National Health Care Anti-Fraud Association, the Blue Cross and Blue Shield Association, Humana, America's Health Insurance Plans, and the Coalition Against Insurance Fraud.

I urge all of my colleagues on both sides of the aisle to join us in cosponsoring this important bill--legislation that I believe really can make a difference. I hope this is a bill we can move quickly. It is a commonsense bill. It will save taxpayer and beneficiary dollars, and it will help to curb the excessive fraud, the unacceptable fraud that is depleting dollars from a program--the Medicare Program--that is already under financial strain.

So let's move this bill. Let's send it to the House and on to the President for his signature as soon as possible.

Mr. President, I again commend the Senator from Florida for his leadership. It has been a great pleasure to work with him on this important issue.

Source