Hultgren targets abuse and waste in Medicare, Medicaid
Rep. Randy Hultgren (R-IL) has co-sponsored a bill to combat waste, fraud and abuse in the Medicare and Medicaid programs.
Hultgren has put his stamp of approval on the Preventing and Reducing Improper Medicare and Medicaid Expenditures (PRIME) Act of 2015. The bipartisan bill amends Titles XVIII and XIX of the Social Security Act. Hultgren said Medicare and Medicaid cost the nation and taxpayers billions in waste and fraud each year. "Putting these programs on sound fiscal footing and protecting our seniors requires rooting out weaknesses that potential scammers can exploit," Hultgren said.
The PRIME Act would phase out the pay-and-chase system by incentivizing Medicare administrative contractors and preventing Medicare thieves from posing as doctors by requiring the U.S. Health and Human Services Department to enhance federal Medicare and state Medicaid data to ensure databases are in line with corrupt actors and unreported deaths.
The act also incentivizes Medicare contractors to avoid overpayments and errors by connecting contract payments to accuracy goals for Medicare contractors and setting up penalties for not meeting the goals; creating harsher penalties for fraudulent use of patient or provider identities; and encouraging seniors and other beneficiaries to report potential fraud and abuse within the Medicare and Medicaid system.