NE Washington News

Lawmakers from various committees and the GOP Doctors Caucus are expressing deep concerns over a reported $3 billion Medicare fraud scheme involving catheter billing. In a letter addressed to the Department of Health and Human Services (HHS) Inspector General and the Centers for Medicare and Medicaid Services (CMS) Administrator, the lawmakers are seeking urgent briefings to address the fraud and prevent its recurrence.

"It is imperative that the U.S. Department of Health and Human Services Office of the Inspector General take immediate action to reduce improper payments and ensure that taxpayer dollars are directed towards the care of our senior citizens whom Medicare is intended to serve," the lawmakers stated in their letter.

The scale of the alleged catheter billing fraud affecting over 450,000 Medicare beneficiaries has raised significant concerns among the lawmakers. They question the efficacy of current fraud detection and prevention measures by CMS and HHS OIG, especially considering the apparent ease with which the fraud was perpetrated.

Public reports estimate the cost of the fraud scheme to be at least $2 billion, but discussions suggest it may be closer to $3 billion. This substantial amount of fraudulent activity has alarmed members of the Energy and Commerce, Ways and Means, Oversight and Accountability committees, as well as the GOP Doctors Caucus.

House Republicans have been vocal about the increasing improper and fraudulent payments in the Medicare and Medicaid programs. Under the Biden administration, Medicare improper payments have reached an estimated total of $87.72 billion, highlighting a concerning trend in fraudulent activities within the healthcare system.

The letter was signed by key members from the Energy and Commerce, Ways and Means, Oversight and Accountability committees, as well as the GOP Doctors Caucus. They are calling for swift action to address the reported fraud and protect Medicare beneficiaries from further exploitation.

The lawmakers are seeking a briefing from the HHS IG and CMS to understand the steps being taken to address the fraud and prevent similar incidents in the future. The urgency of the situation underscores the need for enhanced measures to safeguard taxpayer dollars and uphold the integrity of the Medicare program.