WASHINGTON, DC—The Senate Special Committee on Aging, led by Chairman Bill Nelson (D-FL) and Ranking Member Senator Susan Collins today held a hearing to examine fraud in the Medicare program and ways to protect seniors and taxpayers by preventing fraud.  Among those who testified were a victim of Medicare fraud; an official from the Centers for Medicare & Medicaid Services (CMS), the federal agency that administers the Medicare program; a representative of the HHS Office Inspector General; and a volunteer from the Senior Medicare Patrol, which educates senior citizens about how to recognize and report instances of patterns of fraud.


            One witness, who is a former patient of a doctor who was arrested for Medicare fraud, described undergoing months of expensive and painful intravenous (IV) treatments for an immune system disorder, only to learn later that these treatments were not medically necessary.          


            In response to this testimony, Senator Collins pointed out that Medicare fraud takes not only a financial toll on our nation, but also a human toll. “It is very troubling to learn of instances of Medicare fraud that could seriously jeopardize patient’s health caused by completely unnecessary treatments.”


            In the late 1990’s when Senator Collins was Chairman of the Permanent Subcommittee on Investigations, that panel held a series of hearings to examine the issue of Medicare fraud.  Since that time, some progress has been made.  For example, Medicare contractors are now conducting on-site visits of durable medical equipment suppliers and other providers to make sure that they are legitimate businesses and meet required standards before they enroll in Medicare. And we are doing a better job at screening Medicare providers by using licensing and background checks to stop fraudsters from entering the program in the first place.  Nevertheless, Senator Collins said that con artists have become increasingly sophisticated in their efforts to rip off the Medicare program and more must to be done to combat Medicare fraud before it occurs in the first place.


            In 2012, Medicare reported that it has lost more than $44 billion in improper payments due to waste, fraud, abuse, and mismanagement. Senator Collins said, “The loss of these funds not only compromises the financial integrity of the Medicare program, but it also undermines our ability to provide needed health care services to the more than 54 million older and disabled Americans who rely on this vital program.”


             For decades, the GAO has identified Medicare as being at high risk for improper payments and fraud. 



Hearing witnesses included:

            Bettie Hughes, Senior Medicare Patrol Coordinator, The Senior Alliance; Accompanied by: Patricia Gresko, Medicare Fraud Victim from Romeo, MI;  Brian Martens, Assistant Special Agent in Charge, Miami Office of Investigations, Department of Health and Human Services Office of the Inspector General;  Louis Saccoccio, Chief Executive Officer, National Health Care Anti-Fraud Association; and

Shantanu Agrawal, MD, Deputy Administrator and Director, Center for Program Integrity, Centers for Medicare & Medicaid Services.