Grassley Introduces Bill to Fight Medicare Fraud

Sen. Grassley

On Monday, Sen. Charles Grassley (R-Iowa) introduced the Fighting Medicare Payment Fraud Act of 2009 (S.2774), a measure that would authorize the secretary of the U.S. Department of Health and Human Services to delay payments to Medicare providers suspected of fraud, waste or abuse.

Under the bill, the payments for suspect claims could be delayed by up to 1 year for a category of providers or suppliers, categories of providers or suppliers in a particular geographic area, or individual providers in order to conduct a more thorough review.

The amount of time for an individual provider or supplier left to the determination of the HHS secretary.

“This common-sense change would go a long way in helping to make sure Medicare dollars are going to bona fide providers, instead of fraudulent providers who scam the system,” Grassley said.

The legislation would also require the Office of Inspector General (OIG) to submit recommendations on an annual basis about categories of providers or suppliers in need of additional scrutiny before payments are made under the prompt payment rule.

According to Grassley, the prompt payment provision doesn’t make sense because it creates a situation in which the government has to “pay and chase Medicare fraud,” rather than “working to prevent it in the first place.”