New Bill Aims to Curb Medicare and Medicaid Fraud

Better Databases Could Stop Billions in Improper Payments

SOURCE: AP/Lawrence Jackson

The bill proposed by Sen. Tom Coburn, right, and Sen. Tom Carper, left, aims to reduce Medicare and Medicaid overpayments and prevent a slew of health care scams.

By Pratap Chatterjee | June 22, 2011

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Sens. Tom Carper (D-DE) and Tom Coburn (R-OK) are expected to introduce a bill today that will prevent a slew of health care scams, including stopping “dead” doctors from placing Medicare orders. If approved, the measure is expected to save taxpayers billions of dollars by reducing waste, fraud, and abuse in our health care system.

Medicare and Medicaid account for the bulk of the $125 billion in estimated improper payments that the government makes each year. The federal government made $34.3 billion in questionable payments for traditional Medicare fee-for-service and $22.5 billion for Medicaid in 2010 alone.

The Carper-Coburn bill aims to reduce Medicare and Medicaid overpayments by improving the security of the database of Medicare providers to prevent the theft of physician identities, improve fraud data sharing, and identify more Medicaid overpayments.

In our recent report “Payment Police 2.0” the Center for American Progress urged the government to invest in better-integrated databases of medical claims, check providers and beneficiaries against state and federal death records and other public databases, as well as examine patterns of improper payments not detectable by auditing.

The bill introduced today is a welcome step toward these objectives that we strongly support.

Pratap Chatterjee is a Visiting Fellow at the Center for American Progress.