"The PRIME Act is what I like to call a win-win for those of us who are concerned about protecting Medicare and Medicaid by ensuring that these programs have the resources to provide excellent care for beneficiaries and that taxpayer dollars are spent responsibility and effectively," said Senate Homeland Security and Government Affairs Committee Chairman Tom CarperTom CarperFinancial industry spars with retailers over data breach bill Week ahead: Cyber Command in the spotlight Lawsuit exposes M cybertheft through banking software MORE (D-Del.), the lead Senate sponsor of the bill.
Sen. Tom CoburnTom CoburnMcCain: No third-party foes coming for Trump Tough choice for vulnerable GOP senators: Embrace or reject Trump The Trail 2016: Donald and the Supremes MORE (Okla.), the top Republican on the committee, said the bill reflects the recommendations of many health experts, and is needed to ensure Medicare and Medicaid spending goes to the people who need healthcare access.
"Americans who rely on Medicare and Medicaid expect Congress to work together to reduce waste and fraud," Coburn said. "Improper payments divert scarce resources away from those most in need."
The legislation makes numerous reforms to the two programs, including the imposition of tougher penalties for Medicare and Medicaid fraud, and makes efforts to reduce improper payments under those programs.
The bill also seeks to phase out the "pay and chase" policy, under which the programs generally make payments without making an upfront effort to determine if the recipients of these payments are legitimate. A statement on Coburn's website said Medicare makes tens of billions of dollars in overpayments that are now spotted by private contractors, but only after the fact.
"The program's current pay-and-chase model pays out even suspicious Medicare claims, costing taxpayers billions of dollars," said Rep. Peter Roskam (R-Ill.), the lead House sponsor of the bill. "By combining 21st century technology and common sense solutions, the PRIME Act can help stop fraudsters in their tracks and make Medicare and Medicaid more financially stable for the long term."
The bill would take several other specific steps to stop wasteful Medicare and Medicaid spending. One example is a new effort by the Center for Medicare and Medicaid Services to ensure people don't steal the identities of deceased doctors and use them to claim reimbursements from the government.
The bill also requires Medicare officials to talk more with Medicare beneficiaries to help them spot waste and fraud, including by showing them how to review their Medicare statements for inaccuracies.
Rep. John Carney (Del.), the lead House Democrat on the bill, said he's hopeful that the bipartisan support for cutting waste in order to help seniors can win easy support in Congress this year.
"These days, finding areas where Democrats and Republicans can agree isn't always easy," he said. "But cracking down on waste, fraud and abuse is something we can all get behind."
The Senate bill is S. 1123, and is supported by Sens. Michael BennetMichael BennetDems see political gold in fight over Trump's taxes GOP Senate hopeful wants to go beyond Trump's Muslim ban Lawmakers push to elevate Cyber Command in Senate defense bill MORE (D-Colo.), Chris CoonsChris CoonsDems: Warren ready to get off sidelines Dems pressure Obama on vow to resettle 10,000 Syrian refugees Wildlife crime bill deserves unanimous consent in Congress MORE (D-Del.), Amy KlobucharAmy KlobucharDems pressure Obama on vow to resettle 10,000 Syrian refugees Lobbying World Dem senators: Slash executive pay at pension plans seeking benefit cuts MORE (D-Minn.), Mary LandrieuMary Landrieu oil is changing the world and Washington Ex-Sen. Kay Hagan joins lobby firm Republican announces bid for Vitter’s seat MORE (D-La.), Claire McCaskillClaire McCaskillDems to Clinton: Ignore Trump on past scandals Party chairs see reversal of fortune Why Wasserman Schultz must go MORE (D-Mo.) and Mark WarnerMark WarnerNo time to relax: A digital security commission for the next generation Army posthumously awards female veteran who served as WWII spy The Hill's 12:30 Report MORE (D-Va.). The House bill is H.R. 2305, and is backed by Reps. Ron BarberRon BarberTen House seats Dems hope Trump will tilt House conducts moment of silence for Tucson shooting anniversary Dem files Ethics complaint on Benghazi panel MORE (D-Ariz.), Randy Hultgren (R-Ill.), Tom Reed (R-N.Y.) and Kurt Schrader (D-Ore.).