Congressman Charles W. Boustany, Jr., MD, (R-LA), Chairman of the Subcommittee on Oversight of the Committee on Ways and Means, today announced that the Subcommittee will hold a hearing on improving efforts to combat health care fraud.  The hearing will take place on Wednesday, March 2, 2011, in Room 1100 of the Longworth House Office Building, immediately after a brief Subcommittee organizational meeting beginning at 2:00 P.M.

In announcing the hearing, Chairman Boustany said, “The federal government borrows 41 cents for every dollar it spends, and a growing portion of this is within the Medicare program.  At a time when the federal government is hemorrhaging money, we have to make every effort to stop fraud within the health care system.  It is important that Congress oversee what is happening to this money.  This hearing will explore recent efforts to combat Medicare fraud and what the government can be doing better.  It will also explore what the private sector is doing to stop fraud and how public and private actors might better work together in this effort.”

BACKGROUND:

Health care fraud costs the American taxpayer tens of billions of dollars every year, significantly increasing Medicare spending.  As a GAO-designated “high-risk” program since 1990, Medicare continues to attract those who defraud the government through kickbacks, identity theft, and billing for services and equipment beneficiaries never receive or do not need.  The Medicare program covered 47 million beneficiaries who are senior citizens or have disabilities in 2010 with estimated outlays of $509 billion, according to GAO.    With the Medicare Board of Trustees predicting that Medicare expenditures will reach nearly $1 trillion per year by 2019, a rapidly increasing amount of taxpayer dollars will be vulnerable to fraud unless greater steps are taken to stem the tide.

The Federal Bureau of Investigation estimates that between 3 and 10 percent of health care spending is fraudulent.  With the Centers for Medicare and Medicaid Services estimating current health care spending to be over $2.5 trillion, anywhere from $75 to $250 billion is lost annually to fraud.  As much as $80 billion of this fraud is in the federal health care programs, including up to $50 billion in Medicare alone.  Though it is difficult to accurately quantify the total costs of health care fraud, experts at the National Health Care Anti-Fraud Association predict that with rising health care spending, total health care fraud, waste, and abuse could rise to as high as $330 billion per year by 2013.

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