The government, expanding its battle against waste, fraud and abuse, plans to create a team of "fraud fighters" to crack down on bogus insurance claims and other schemes to bilk the nation's Medicare program, President Clinton said yesterday.
Clinton said his fiscal 2001 budget, scheduled for release next month, will propose placing federal agents in the offices of health insurance companies and other contractors that process Medicare bills and will seek extra funds to finance "new technologies" to track false claims filed by health care providers.
"Medicare fraud and waste are more than an abuse of the system, they are an abuse of the taxpayer," Clinton said. "By overbilling, charging for phony procedures and selling substandard supplies, Medicare cheats cost taxpayers hundreds of millions a year."
In his weekly radio address, Clinton urged Congress to support his proposed crackdown on fraud. He asked Congress to give Medicare the power to broaden the pool of private sector companies eligible to provide program services and process health care claims. Current law limits the program's choices of contractors and makes it difficult to discipline them, officials said.
Rep. J. C. Watts (Okla.), the chairman of the House Republican Conference, commended Clinton for attacking Medicare fraud. "His fight is a valid one," Watts said in a statement.
But Watts also made it clear that Republicans will scrutinize the president's budget proposal and the manner in which it is to be implemented. "Republicans know that you cannot fight waste, fraud and abuse in Washington by adding on more Washington bureaucrats with bigger budgets. You can't fight a fire by adding gasoline," he said.
Intensified federal efforts to prevent fraud, abuse and mismanagement in Medicare have been going on since 1990, when congressional auditors designated the program as "high-risk" and in need of significant reforms and modern computer systems.
The Clinton administration, for its part, has stepped up law enforcement efforts against companies and individuals engaging in health care fraud, and the enforcement efforts appear to be paying off. Unnecessary Medicare expenditures dropped from $23.2 billion in 1996 to $12.6 billion in 1998, officials said.
A report released by the White House said the government last year won or negotiated more than $524 million in judgments, settlements and administrative orders in health care fraud cases. Of that, the government collected $490 million, with the bulk of the money returned to the Medicare trust fund, the report said.
Clinton said the Medicare program also is showing success in catching fraudulent claims and prevented $5.3 billion worth of inappropriate payments last year.
The president's remarks, taped in Pasadena, Calif., came just days after the Justice Department announced it had settled a health care fraud case involving a national chain of kidney dialysis centers for nearly $500 million, the largest health care settlement in the department's history.
The settlement agreement with Fresenius Medical Care North America included allegations that the company caused Medicare to pay for thousands of needless tests and procedures. Clinton cited the case in his radio address, saying "the more tests providers ordered, the more kickbacks they got in return--lavish dinners, yacht trips."
Clinton's pledge to go after waste and fraud in Medicare also comes only days before House Budget Committee Republicans expect to issue a report highlighting the government's financial management problems.
Using studies prepared by the General Accounting Office, the congressional watchdog agency, and Cabinet department inspectors general, the Budget Committee found 17 major federal programs made $19.1 billion in improper payments during fiscal 1998.
But a number of Republicans argue that those figures underestimate the size of the government's financial mismanagement woes. The staff of the Senate Governmental Affairs Committee identified about $210 billion in federal overpayments, erroneous payments and wasteful practices in a study last summer.