On May 24th, the Subcommittee on Oversight and Investigation held a hearing entitled “Medicare and Medicaid Program Integrity: Combatting Improper Payments and Ineligible Providers.” The hearing was held based on recent reports from the Government Accountability Office (“GAO”) and the Department of Health and Human Services (“HHS”) Office of the Inspector General (“OIG”) presenting evidence of substantial fraud and abuse in the Medicare and Medicaid programs. The hearing examined two distinct challenges faced by the Centers for Medicare and Medicaid Services (“CMS”) in implementing these programs: (1) preventing improper payments; and (2) ensuring that providers are properly eligible and enrolled. The witnesses included CMS’ Deputy Administrator and Director of the Center for Program Integrity, GAO’s Director of Audit Services and an OIG’s Assistant Inspector General.
Chairman Tim Murphy stated that last year HHS estimated approximately $89 billion dollars were made in improper payments through Medicare and Medicaid; meaning that the federal government cannot verify the accuracy of 1 in every 10 payments. While members of the Subcommittee expressed continued concerns regarding fraud within the Medicare and Medicaid programs, they agreed that the Subcommittee will hold a follow-up hearing in one year to measure CMS’ progress.