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Press Release

CMS Fails to Provide Medicare/Medicaid Fraud Estimate


WASHINGTON, DC -The House Energy and Commerce Subcommittee on Oversight and Investigations, chaired by Rep. Cliff Stearns (R-FL), today concluded a hearing on waste, fraud, and abuse in Medicare and Medicaid.  The amount of fraud in the Medicare and Medicaid programs has risen steadily over the last forty years, in spite of promises from numerous administrations to eliminate such fraud. GAO has continually designated Medicare as a “High Risk” since 1990 and Medicaid since 2003.

During the hearing, an administration witness from the Centers for Medicare and Medicaid Services failed to even venture an estimate on the amount of fraud, raising questions regarding President Obama’s promise to fund the new health care law in part by saving billions of dollars by eliminating waste, fraud and abuse. Members of the subcommittee also expressed concern about the potential increase in fraud as 20 million individuals are expected to be added to Medicaid as a result of the new health care law.

Stearns Highlights Medicare and Medicaid’s “High Risk” Nature
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“Recently the Government Accountability Office listed the Medicare and Medicaid programs as “˜High Risk’ programs. High Risk Programs are identified as having “˜greater vulnerability to fraud, waste, abuse, and mismanagement.” 

CMS Fails to Provide Fraud Estimate
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Although recognizing the occurrence of waste, fraud, and abuse, the administration’s witness from the CMS was unable to even venture an estimate on the amount, although Stearns mentioned estimates of $60 to $90 billion a year.

Health Care Law Won’t Come Close to Solving Problem
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“Even if you took CBO’s suggestions that the additional funding in the federal health reform legislation could help save $6 or $7 billion that’s hardly enough to get close to the estimates that the OIG says is the problem today,” said Craig Smith, former General Counsel of Florida’s Agency for Health Care Administration.

Stearns concluded, “The purpose of the Oversight and Investigations Subcommittee is to ferret out details We are going to forward these recommendations to the Health Subcommittee and they can hold a hearing and then follow up with legislation to curb this fraud.”



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