WASHINGTON, D.C. – House Ways and Means Oversight Subcommittee Chairman Vern Buchanan (R-FL) announced today that the Subcommittee will hold a hearing, entitled “Efforts to Combat Waste, Fraud, and Abuse in the Medicare Program,” on Wednesday, July 19, at 10:00 AM in room 1100 of the Longworth House Office Building. The hearing will focus on how the Centers for Medicare and Medicaid Services (CMS) identifies and combats waste, fraud, and abuse, in both traditional Medicare and the Medicare Advantage program.

Upon announcing the hearing, Chairman Buchanan said:

“Nearly 60 million Americans, including four million in my home state of Florida, rely on the Medicare program to provide high value care. However, Medicare is one of the largest sources of waste, fraud, and abuse in the government. Americans expect and deserve that all taxpayer dollars are well spent. I look forward to exploring ways we can assist CMS in improving Medicare program integrity activities.”   

BACKGROUND
Created in 1965, Medicare provides health coverage to individuals 65 and over and certain individuals with disabilities. Medicare covers nearly 60 million Americans. Due to the vast size and complexity of the program, Medicare is particularly vulnerable to fraud and other improper payments.

CMS relies on multiple contractors to manage program integrity efforts, including prevention, detection, and recovery. Although most improper payments are due to problems with underlying documentation and medical necessity errors, rather than fraud, improper payments pose a substantial financial challenge to ensuring the long-term viability of the Medicare program. In the FY 2016 Agency Financial Report, the Department of Health and Human Services estimated $59.6 billion was spent on improper payments program-wide, the overwhelming majority of which occurred in fee-for-service Medicare.