Senators demand more data on Medicare fraud prevention efforts

Sen. Orrin Hatch (R-UT)

A multimillion dollar Medicare fraud-fighting command center unveiled by the federal government a week ago is already drawing fire from two Republican lawmakers.

In a letter to Marilyn Tavenner, acting administrator for the Centers for Medicare & Medicaid Services, Senators Orin Hatch (R-UT) and Tom Coburn (R-OK) asked CMS to provide more data on the Fraud Prevention System used by the new command center and by regional fraud-fighting offices across the country.

More specifically, they asked for more information on performance metrics, the targeting of claims for review and actual program results. Hatch and Coburn wrote that CMS responses to previous queries have been inadequate in light of recent Government Accountability Office and Office of the Inspector General investigations.

The senators suspect that the government's return on investment has not been significant. Further, they argue that CMS “has not been fully transparent regarding what progress the agency is making in implementing the system and how successful the efforts of the system have been to date.” They requested that CMS provide the desired data by Aug. 31.

Auditors working for CMS are tasked with identifying suspicious billing patterns for all Medicare Part A, Part B, and durable medical equipment claims before they are paid, including those filed by nursing homes. CMS gave members of the media a tour of the $3.6-million facility this week.

Click here to read Hatch and Coburn's letter to CMS.