"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 CarperYahoo hack spurs push for legislation Election-year politics: Senate Dems shun GOP vulnerables Overnight Healthcare: McConnell unveils new Zika package | Manchin defends daughter on EpiPens | Bill includes M for opioid crisis MORE (D-Del.), the lead Senate sponsor of the bill.
Sen. Tom CoburnTom CoburnRyan calls out GOP in anti-poverty fight The Trail 2016: Words matter Ex-Sen. Coburn: I won’t challenge Trump, I’ll vote for him 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 BennetSenate poll raises Republican hopes in Pennsylvania, Florida Podesta floated Bill Gates, Bloomberg as possible Clinton VPs GOP Senate candidate reverses course, says he’ll vote Trump MORE (D-Colo.), Chris CoonsChris CoonsDem blasts Trump on 'jail' line: 'That's what dictators do' Election-year politics: Senate Dems shun GOP vulnerables Overnight Healthcare: McConnell unveils new Zika package | Manchin defends daughter on EpiPens | Bill includes M for opioid crisis MORE (D-Del.), Amy KlobucharAmy KlobucharGreat Lakes senators seek boost for maritime system Podesta floated Bill Gates, Bloomberg as possible Clinton VPs EpiPen maker to pay 5M to settle overcharging case MORE (D-Minn.), Mary LandrieuMary LandrieuTrump’s implosion could cost GOP in Louisiana Senate race Louisiana needs Caroline Fayard as its new senator La. Senate contender books seven-figure ad buy MORE (D-La.), Claire McCaskillClaire McCaskillMcCaskill offers Trump 'Mean Girls' advice Trump's taxes bump Miss Universe from headlines Dem on NYT report: Trump 'walks away with a golden ticket' MORE (D-Mo.) and Mark WarnerMark WarnerPolicymakers face long road to financial technology regulation Liberal groups urge Schumer to reject Bayh for Banking gavel Why Yahoo's breach could turn the SEC into a cybersecurity tiger 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.).