Bills aim to cut Medicare, Medicaid fraud

Washington -- Congress is attempting to step up efforts to combat fraud and abuse in the Medicare and Medicaid programs. Two new bills were introduced May 5 that aim to reduce the prevalence of identity theft in Medicare and increase transparency of Medicaid payment data.

The Seniors and Taxpayers Obligation Protection Act would require the Health and Human Services secretary to stop the department from using Social Security numbers as the beneficiary identifier on Medicare cards. The STOP Act also would improve the department's fraud detection methods and would place billing statements under increased scrutiny.

"These steps will help protect seniors and doctors from identity theft, keep criminals from becoming Medicare providers, and strengthen data-mining and matching to catch criminals currently in Medicare in real time," said Sen. Mel Martinez (R, Fla.), who introduced the bill along with Sen. John Cornyn (R, Texas).

Medicare fraud and abuse costs taxpayers up to $60 billion each year, the lawmakers said. The HHS Office of Inspector General said it opened 1,750 new health care fraud investigations in fiscal 2008.

"This legislation will better detect and prevent abuse of the system to stop Medicare fraud before it starts," Cornyn said.

Both lawmakers also introduced the second bill, the Medicaid Accountability through Transparency Act, which would require HHS publicly to disclose Medicaid payment data that it collects. Under the bill, the HHS secretary would establish a publicly accessible Web site containing nonaggregated Medicaid claims payment data that has been de-identified. The information must be provided in a format that is easily accessible, useable and understandable to the public, and it must be collected at least once per calendar year.

To ensure compliance, the bill imposes a penalty of $25,000 per day for any period in which the HHS secretary has found that a state has not fully complied with the data collection requirements.