Q&A: Fraud Drives Up Healthcare Costs

Q&A: Fraud Drives Up Healthcare Costs

Q: How would your fraud prevention bill recover tax dollars and improve healthcare?

A: Americans work hard for their money. As a taxpayer watchdog, I take seriously the responsibility to ensure every tax dollar collected for government services is spent as intended. From the Pentagon to public healthcare programs, I lead efforts at the policymaking tables to sharpen fraud-fighting tools and protect taxpayer money. Starting with my decades-long crusade to empower whistleblowers, my updates to the False Claims Act have recouped more than $85 billion for taxpayers and saved tens of billions more by deterring would-be fraudsters. Notably, of the $6.8 billion in settlements and judgments in just the last fiscal year, the lion's share of the recoveries was from the healthcare industry. The Department of Justice lasered in on three areas of widespread fraud in the U.S. healthcare system: Medicare managed care, prescription drugs and medically unnecessary care.

Building on this success, I recently joined forces with senators on the Senate Finance Committee to beef up resources to combat fraud, waste and abuse across federal health programs that serve families, kids and seniors. Federal healthcare spending is expected to exceed $24 trillion over the next decade. Every dollar lost to fraud, improper billing or neglect is another squandered tax dollar and one less dollar for patient care.

As a former chairman of the Senate Finance Committee, I'm glad the committee's current chairman, Sen. Mike Crapo, and ranking member, Sen. Ron Wyden, teamed up with me and Sen. Catherine Cortez Masto. Our bill, the Health Care Fraud Prevention and Enforcement Act, would help ensure long-term, stable funding to prevent, detect and prosecute fraud and keep pace with evolving, sophisticated schemes. According to estimates from the nonpartisan Congressional Budget Office, our bill would save taxpayers at least $45 billion.

Specifically, our bipartisan bill would improve the Health Care Fraud and Abuse Control program to better scrutinize federal health programs and scrape fraud out of the taxpayer funding pipeline. Partners across multiple federal agencies will have more resources to coordinate and combat fraud in Medicaid, Medicare, the Affordable Care Act Health Insurance Marketplace, the Children's Health Insurance Program, as well as related private insurance programs. Deploying better-equipped fraud fighters also put would-be fraudsters on notice that bilking taxpayers doesn't pay. The bill requires timely reporting to track the fraud and abuse control program's effectiveness and asks the Government Accountability Office to report on its performance for the first time in over a dozen years. The Trump administration has made fraud prevention, detection and prosecution a high priority, a mission I've pursued throughout my time in Congress on behalf of the American people. I welcome this all-hands-on-deck effort and will continue working to ensure all the anti-fraud tools in the federal arsenal are razor sharp, including civil enforcement tools, such as my False Claims Act.

Q: How will Iowa benefit from a new federal grant to target fraud and financial crimes?

A: During his confirmation hearing, the U.S. Assistant Attorney General for the National Fraud Enforcement Division at the Department of Justice said he is committed to "prosecute criminals who exploit the generosity of a country by stealing from taxpayer-funded programs." That's music to the ears of Iowans who are absolutely fed up with their hard-earned money lining the pockets of scam artists, such as the outrageous Covid-era schemes in Minnesota and elsewhere. I supported Colin McDonald to fill this new role at the Justice Department, who is leading efforts to snuff out the unacceptable and pervasive crimes of federal program fraud.

Recently, the U.S. Department of Justice awarded nearly $4 million to the Iowa Attorney General's office to coordinate efforts to fight Medicaid and public benefit fraud. This grant provides funding to hire and assign five prosecutors to serve as Special Assistant United States Attorneys within the U.S. Attorney's offices in Iowa that are based in Des Moines and Cedar Rapids. This federal funding reflects how the Trump administration is putting money where its mouth is: boots on the ground to fight fraud, protect the integrity of government programs that serve Iowans and hold wrongdoers accountable.

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