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Questions Raised on the Effectiveness of Medicare Fraud Program

April 25, 2012

Washington, DC – Today, Ways and Means Subcommittee on Oversight Chairman Charles Boustany, Jr., M.D. (R-LA) sent a letter to Centers for Medicare & Medicaid Services (CMS) Acting Administrator Marilyn Tavenner inquiring into the performance, effectiveness and evaluation of the Medicare Integrity Program (MIP) and its contractors.  Recent data indicates that CMS spends over $1 billion on contractors annually, depending on them to prevent the estimated $48 billion in Medicare payments lost to fraud, waste or abuse each year.  However, their performance is not measured using any consistent metrics.  The letter raises questions as to whether the program and contractors are meeting the standards that American taxpayers and the seniors that rely on the Medicare program deserve.

In the letter, the Chairman stated, “As program integrity efforts are critical to the protection of Medicare Trust Funds, it is essential that Congress conduct oversight to ensure CMS is engaging in these efforts effectively and that taxpayers are getting value for the over $1 billion that is spent on MIP activities annually.”
The full letter can be read here.