Senators Introduce Bipartisan Legislation to Curb Medicare and Medicaid Waste, Fraud, and Abuse

WASHINGTON – Today, Sens. Tom Carper (D-Del.), Michael Enzi (R-Wyo.), Sheldon Whitehouse (D-R.I.) and Ron Johnson (R-Wis.) introduced bipartisan legislation to combat and prevent waste, fraud, and abuse in Medicare and Medicaid.

The “Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2015,” or the PRIME Act, would address a set of problems that lead to the loss of billions of dollars to waste and fraud in Medicare and Medicaid every year. The legislation would enact stronger penalties for Medicare and Medicaid fraud; establish stronger fraud and waste prevention strategies to help phase out the practice of “pay and chase”; curb the theft of beneficiary identities; expand the work of the Senior Medicare Patrol; and improve the sharing of anti-fraud data across agencies. Most of the provisions are based on the findings and recommendations of the Government Accountability Office, the Health and Human Services Inspector General, and other experts and stakeholders.

Sen. Carper: “Medicare and Medicaid are two of our nation’s most critical safety-net programs that millions of our most vulnerable Americans – the poor, the elderly, and the disabled – rely on every day for quality health care. But every year, these programs lose billions of dollars to waste and criminal activity. We have a responsibility to make sure these programs have the resources they need to provide excellent care for beneficiaries, and at the same time, ensure that taxpayer dollars are spent responsibly and effectively. The PRIME Act of 2015 builds on previous reforms, taking common sense steps to fortify the integrity of Medicare and Medicaid, and will yield better stewardship of taxpayer dollars by addressing the programs’ vulnerabilities to waste, fraud, and abuse. I will continue to work with my colleagues in Congress to advance this important bill and other common-sense reforms to better protect Medicare and Medicaid against instances of waste, fraud, and abuse.”

Sen. Enzi: “Every year billions of taxpayers’ dollars are wasted through improper and fraudulent payments in Medicare and Medicaid. This legislation puts in place common sense changes to help root out and cut that waste to ensure that these programs’ resources get to where they are most needed.”

Sen. Whitehouse: “Rising costs, fraud, and abuse threaten to undermine Medicare and Medicaid, programs Rhode Islanders depend on. We have an obligation to ensure that Medicare and Medicaid dollars are spent keeping Americans healthy, not lining the pockets of predatory opportunists. This important legislation would help prevent fraudulent claims from being paid out in the first place and strengthen penalties for those who break the law.”

Sen. Johnson: “Strengthening Medicare and Medicaid’s program integrity and transparency is critical to protecting taxpayer dollars while ensuring that beneficiaries are receiving appropriate care. I am pleased to join with Senators Carper, Enzi and Whitehouse in support of this sensible, bipartisan bill that takes steps in the right direction towards addressing the tens of billions of dollars of waste, fraud and abuse in the Medicare and Medicaid programs.”

The PRIME Act of 2015 is also cosponsored by Sens. Chris Coons (D-Del.), Rob Portman (R-Ohio), Amy Klobuchar (D-Minn.), Tom Cotton (R-Ark.), Claire McCaskill (D-Mo.), John Barrasso (R-Wyo.), Joe Manchin (D-W.Va), Kelly Ayotte (R-N.H.), John Thune (R-S.D.) and Jeanne Shaheen (D-N.H).

The PRIME Act of 2013 was originally introduced by Sens. Carper and Tom Coburn (R-Okla.), and Reps. Peter Roskam (R-Ill.) and John Carney (D-Del.) in June 2013. In February 2015, Reps. Roskam and Carney reintroduced the legislation in the House of Representative as the PRIME Act of 2015, which was included in legislation agreed to by the House Ways and Means Committee in the Protecting Integrity of Medicare Act (PIMA).