Hearing Description: The House Energy and Commerce Health Subcommittee recently met to examine the current management of Medicare by CMS. A representative from the Office of the Inspector General reported that CMS was not following suggestions given to them and they could be doing a lot more to address fraud and abuse.
Hearing Date: March 4, 2014
Hearing Summary: Prepared for AAPS by the Market Institute
The Health Subcommittee recently met to examine how more effectively managing Medicare can better protect seniors. In his opening statement, Chairman Joe Pitts (R-PA) said improper Medicare payments totaled over $49.8 billion for FY 2014. Independent estimates of the real cost of waste, fraud, and abuse in Medicare are much higher. The Medicare Trust Fund is set to go bankrupt sometime in the next decade. Congressional action is necessary to protect seniors. The hearing will be a first step toward a broader long-term effort to build consensus about the best ways to modernize the Medicare program.
The first witness, Kathleen King, Director of Healthcare at the Government Accountability Office testified in her opening statement that substantial changes in the law regarding contract requirements and other parameters of the program—including payment rates—have contributed to fluctuations in the number of contracts and enrolled beneficiaries over the years. Medicare spending on the Part D program has been lower than originally anticipated.
The second witness, James Cosgrove, Director of Healthcare at the Government Accountability Office submitted a joint statement with colleague Kathleen King.
The third witness, Robert Vito, Regional Inspector General at HHS, Office of the Inspector General testified in his opening statement that CMS relies on contractors to administer the Medicare program and is responsible for overseeing the contractors’ performance. With billions of dollars at stake, it is critical CMS perform regular and rigorous oversight of its MA and Part D plans. OIG has found that CMS does not properly oversee and leverage available data, address contractor problems in a timely manner, and communicate with beneficiaries for anti-fraud solutions.
In response to questioning, Robert Vito said:
- CMS has only voluntarily collected information OIG has requested; they were advised to collect even more data to fight fraud and abuse
- Legislation could be the solution to getting CMS to address these issues
- OIG has an 8 dollar return (on 1 dollar) and would benefit from more funding
- More funds should be allocated to evaluating and auditing the Medicare program
Hearing Website::
http://energycommerce.house.gov/hearing/keeping-promise-how-better-managing-medicare-can-protect-seniors
Links to Testimony:
Kathleen King, Director
Health Care Government Accountability Office
Click to access HHRG-113-IF14-Wstate-KingK-20140304.pdf
James Cosgrove, Director
Health Care Government Accountability Office
Click to access HHRG-113-IF14-Wstate-CosgroveJ-20140304.pdf
Robert Vito
Regional Inspector General
Department of Health and Human Services, Office of Inspector General
