"The PRIME Act is what I like to call a win-win for those of us who are concerned about protecting Medicare and Medicaid by ensuring that these programs have the resources to provide excellent care for beneficiaries and that taxpayer dollars are spent responsibility and effectively," said Senate Homeland Security and Government Affairs Committee Chairman Tom CarperTom CarperA guide to the committees: Senate Senate advances Trump's Commerce pick Warren: Trump's EPA pick the 'attorney general for Exxon' MORE (D-Del.), the lead Senate sponsor of the bill.
Sen. Tom CoburnTom CoburnCoburn: Trump's tweets aren't presidential The road ahead for America’s highways Rethinking taxation MORE (Okla.), the top Republican on the committee, said the bill reflects the recommendations of many health experts, and is needed to ensure Medicare and Medicaid spending goes to the people who need healthcare access.
"Americans who rely on Medicare and Medicaid expect Congress to work together to reduce waste and fraud," Coburn said. "Improper payments divert scarce resources away from those most in need."
The legislation makes numerous reforms to the two programs, including the imposition of tougher penalties for Medicare and Medicaid fraud, and makes efforts to reduce improper payments under those programs.
The bill also seeks to phase out the "pay and chase" policy, under which the programs generally make payments without making an upfront effort to determine if the recipients of these payments are legitimate. A statement on Coburn's website said Medicare makes tens of billions of dollars in overpayments that are now spotted by private contractors, but only after the fact.
"The program's current pay-and-chase model pays out even suspicious Medicare claims, costing taxpayers billions of dollars," said Rep. Peter Roskam (R-Ill.), the lead House sponsor of the bill. "By combining 21st century technology and common sense solutions, the PRIME Act can help stop fraudsters in their tracks and make Medicare and Medicaid more financially stable for the long term."
The bill would take several other specific steps to stop wasteful Medicare and Medicaid spending. One example is a new effort by the Center for Medicare and Medicaid Services to ensure people don't steal the identities of deceased doctors and use them to claim reimbursements from the government.
The bill also requires Medicare officials to talk more with Medicare beneficiaries to help them spot waste and fraud, including by showing them how to review their Medicare statements for inaccuracies.
Rep. John Carney (Del.), the lead House Democrat on the bill, said he's hopeful that the bipartisan support for cutting waste in order to help seniors can win easy support in Congress this year.
"These days, finding areas where Democrats and Republicans can agree isn't always easy," he said. "But cracking down on waste, fraud and abuse is something we can all get behind."
The Senate bill is S. 1123, and is supported by Sens. Michael BennetMichael BennetA guide to the committees: Senate Senate advances Trump's Commerce pick Senate Dems move to nix Trump's deportation order MORE (D-Colo.), Chris CoonsChris CoonsSenate advances Trump's Commerce pick Senate Dems move to nix Trump's deportation order Senate Dem: Trump will hurt Gorsuch's confirmation by undermining judiciary MORE (D-Del.), Amy KlobucharAmy KlobucharDrug importation won't save dollars or lives Senators ask feds for ‘full account’ of work to secure election from cyber threats Sanders, not Trump, is the real working-class hero MORE (D-Minn.), Mary LandrieuMary LandrieuFive unanswered questions after Trump's upset victory Pavlich: O’Keefe a true journalist Trump’s implosion could cost GOP in Louisiana Senate race MORE (D-La.), Claire McCaskillClaire McCaskillThe DNC in the age of Trump: 5 things the new chairman needs to do A guide to the committees: Senate Juan Williams: Senate GOP begins to push Trump away MORE (D-Mo.) and Mark WarnerMark WarnerDems worry too much about upsetting others. That needs to stop. Washington-area lawmakers request GAO report on DC Metro Trump's pick for intel chief to get hearing next week MORE (D-Va.). The House bill is H.R. 2305, and is backed by Reps. Ron BarberRon BarberGiffords to lawmakers avoiding town halls: 'Have some courage' Ten House seats Dems hope Trump will tilt House conducts moment of silence for Tucson shooting anniversary MORE (D-Ariz.), Randy Hultgren (R-Ill.), Tom Reed (R-N.Y.) and Kurt Schrader (D-Ore.).