WASHINGTON- Today, U.S. Senator Tom Carper (D-Del.), Chairman of the Homeland Security and Governmental Affairs Committee, highlighted the FY 2013 Improper Payments Rates for the Medicare and Medicaid programs, released in the Department of Health and Human Services’ (HHS) FY 2013 Agency Financial Report. The numbers show that both Medicare and Medicaid remain at risk of improper, or mistaken, payments. The report found that $49.9 billion in Medicare payments in 2013 can be considered improper, an increase from $44.3 billion in 2012. The Medicaid program, however, has shown progress in cutting improper payments from $19. 2 billion in 2012, to $14.4 billion in 2013.
“Today’s disclosure by the Centers for Medicare and Medicaid (CMS) is an important reminder that these programs remain at risk of improper payments,” said Chairman Carper. “While I’m encouraged that the Medicaid program has taken significant steps to cut down on mistaken payments, I’m concerned that there has been an increase in the improper payments made in Medicare. I often like to say that the road to improvement is always under construction, and the same is true for improving accuracy in Medicare and Medicaid payments. Just last week my colleagues on the Finance Committee approved legislation, based largely on the bipartisan PRIME Act, which I introduced with Dr. Coburn, that would help cut down on waste, fraud and abuse. I’m hopeful that we can soon enact these bipartisan reforms to help Medicare better manage its funding in the long run.”
The PRIME Act was introduced by Senators Carper and Tom Coburn (R-Okla.), Ranking Member of the Homeland Security and Government Committee, and Representatives Peter Roskam (R-Ill.) and John Carney (D-Del.) in June 2013. On December 12, 2013, the Senate Finance Committee included portions of the PRIME Act as an amendment to the SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013. Among its provisions, the amendment would: curb improper or mistaken payments made by Medicare and Medicaid; establish stronger fraud and waste prevention strategies within Medicare and Medicaid to help phase out the practice of "pay and chase”; take steps to help states identify and prevent Medicaid overpayments; and improve the sharing of fraud data across state and federal agencies and programs.