Chairman Guthrie Op-Ed: Republicans Are Ending the Healthcare Fraud Free-for-All
WASHINGTON, D.C. – The following op-ed, authored by Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, appeared in the Washington Examiner last week:
“For too long, fraudsters have been treating programs funded by families’ hard-earned tax dollars like a piggy bank.
“Thanks to previous Democratic administrations, the American healthcare system has become particularly vulnerable to criminals, illegal immigrants, and fraudsters who are taking advantage of the system, rather than promoting the health and well-being of our expectant mothers, low-income seniors, children, and individuals with disabilities — those who are most in need of these programs.
“With President Donald Trump in the White House, the era of unchecked spending and blatant abuse of our government health programs is over. Congressional passage of the Working Families Tax Cuts has provided our nation with the chance to restore these programs to provide care for the people they were meant to serve.
“The Energy and Commerce Committee is tasked with the important role of implementing policies that protect our most vulnerable people, rooting out fraud from our healthcare system, and restoring the long-term integrity of vital safety net programs.
“To achieve that goal, we have taken steps this Congress to put these programs back on track.
“We have cracked down on states’ abuses of financing gimmicks.
“We instilled commonsense community engagement requirements for able-bodied, unemployed adults receiving Medicaid — a policy that nearly 8 in 10 people support.
“And we incorporated a historic, $50 billion fund strictly for rural communities — the Rural Health Transformation Program — to bolster health initiatives and invest in hospitals and providers. All 50 states are beginning to see the benefits of the RHT Program.
“And perhaps most critically, we found $1.1 trillion in waste, fraud, and abuse in these programs — funded using your taxpayer dollars.
“Waste, fraud, and abuse can have a devastating effect on our safety net programs, so we will continue to focus our work on rooting these out of the programs designed to serve the most vulnerable.
“In addition to the policies we passed into law with H.R. 1, the Working Families Tax Cuts, last month the committee released a major report on Medicare and Medicaid fraud, the culmination of a thorough investigation holding states accountable for their part in opening the floodgates of fraud.
“While Democrats continue to deny fraud has even occurred in the first place, Republicans have dug into how criminal organizations and fraudsters are abusing the systems. Recently, Operation Gold Rush resulted in 11 individuals being charged in ‘the largest case by loss amount ever charged by the Department of Justice.’ This scheme involved members of Russian organized crime who purchased 30 small medical supply companies already enrolled in Medicare, billing more than $10.6 billion in fraudulent urinary catheter claims using stolen beneficiary information.
“The report also examines what steps some states are actively taking to protect government health programs from exploitation, such as Nebraska, which highlighted a recent initiative to reassign any service that does personal care to be high risk, triggering higher security and screening requirements. Because every dollar that lines a fraudster’s pocket is a dollar coming out of the program accounts intended for people in need.
“We’re holding some states accountable for turning a blind eye, and in other cases we’re building on what they’re doing to fortify against future fraud.
“In fact, members of our committee recently introduced 14 pieces of legislation that provide incentives for states to go after fraud, be better stewards of taxpayer funding, and implement new strategies to crack down on fraud.
“This legislative package provides meaningful policies to combat the criminal activity harming our communities, with bills to enhance access to new, cutting-edge technologies that help identify waste, fraud, abuse, and improper payments. Importantly, the package also bolsters enforcement tools and even provides new incentives for states to identify and recover improper spending.
“In order to promote policies that hold states accountable, we must also seek ways to ensure that states will see the benefits of their investments in combating fraud.
“With this new Republican-championed package to promote program integrity in federal health programs, as well as our important work rooting out waste, fraud, and abuse when crafting H.R. 1, taxpayers can have greater confidence in federal programs and vulnerable people will be protected from bad actors looking for a payday.
“In fact, the Office of the Assistant Secretary for Planning and Evaluation at the Department of Health and Human Services found that our Medicaid community engagement requirements in the WFTC could increase family net income by $12,034 and reduce poverty by up to 2.9 million.
“Going even further, ASPE also found provider tax and state-directed payment policies in the WFTC are expected to reduce healthcare prices by up to 3.5% and reduce costs in Medicaid, commercial insurance, and Medicare.
“Those are just a few examples of how the law is strengthening, securing, and sustaining our government health programs and uplifting patients. We are already seeing how the Working Families Tax Cuts is making a real impact for people across the country.
“Our new legislative package continues the fight against fraud by building on the best ideas in preventing and combating fraud, turbocharging enforcement tools and making sure states have skin in the game.
“The diagnosis is clear: Going after waste, fraud, and abuse can restore our healthcare systems. Building on the Working Families Tax Cuts, including our new legislative package, our committee will continue working to strengthen, secure, and sustain our critical safety net programs for generations to come.”