Washington, DC – Today, Ways and Means Subcommittee on Oversight Chairman Charles Boustany, Jr., M.D. (R-LA) sent a letter to Health and Human Services (HHS) Secretary Sebelius, Department of Justice (DOJ) Attorney General Eric Holder, and Centers for Medicare & Medicaid Services (CMS) Acting Administrator Marilyn Tavenner regarding Medicare fraud.  The Government Accountability Office (GAO) estimates that nearly $48 billion in Medicare payments were subject to fraud, waste, or abuse during fiscal year 2010.  

In March 2011, the Subcommittee on Oversight held a hearing on public and private sector efforts to combat health care fraud.  During the hearing, CMS Deputy Director Dr. Peter Budetti stated the “Administration has made a firm commitment to rein in fraud and wasteful spending, and with the Affordable Care Act, we have more tools than ever before to implement important and strategic changes.”  However, a year later, recent reports from the Houston Chronicle document large outliers in Medicare reimbursement, raising new questions about Medicare fraud in the Houston area.

In the letter, Chairman Boustany requested HHS Secretary Sebelius and Attorney General Holder investigate the allegations the Houston Chronicle documented and provide information on criminal health care fraud investigations conducted by the Health Care Prevention and Enforcement Action Team (HEAT).

Additionally, Chairman Boustany requested that CMS identify areas vulnerable to Medicare fraud and what CMS is doing to combat additional fraudulent actions.

The letter sent to HHS and DOJ can be read here.

The letter sent to CMS can be read here.