2009-S2128 on Oct 29, 2009

CONGRESSIONAL SUMMARY:
• There is hereby established, in the Department of H, the Office of the Deputy Secretary for Health Care Fraud Prevention.
• The Office shall provide contracts for the design, development, and operation of a predictive model antifraud system, based on the risk level assigned to claims activity, and develop a comprehensive antifraud database for health care activities carried out or managed by Federal health agencies.
• The Office shall promulgate and enforce regulations relating to the reporting of data claims to the health care antifraud system.

SPONSOR'S INTRODUCTORY REMARKS:

Sen. LeMIEUX. The current proposal for health care is a $1 trillion proposal. If we spent as much time caring about the money we are spending now, as opposed to the money some in this Chamber want to spend, I suspect we could find plenty of money to either return to the people or to find money for these new programs.

Today, I wish to talk about just such an idea, an idea to recover some of the waste, fraud, and abuse that is currently happening in our current provision of health care--in Medicare and Medicaid. Estimates are that some $60 billion to a staggering $226 billion a year to waste, fraud, and abuse.

This health care proposal that we are discussing in the Senate is $1 trillion over 10 years. That is about $100 billion a year. We may be wasting $226 billion a year. If we captured just half of that, we might be able to pay for this program.

Why can't we do the same thing the credit card companies are doing for health care? Why can't we use a predictive modeling system that says a health care claim is not going to be paid when a red flag comes up? Right now we are on a pay-and-chase system. If we put this predictive modeling system in, it stops the fraud before it happens. The credit card industry benchmark is 0.1% while fraud losses in the health care business run from 3% to 14%.

Participating counts on VoteMatch question 5. Question 5: More federal funding for health coverage Scores: -2=Strongly oppose; -1=Oppose; 0=neutral; 1=Support; 2=Strongly support.
• Topic: Health Care
• Headline: Establishment of Office of Health Care Fraud Prevention (Score: -1)
• Headline 2: Sponsored bill establishing Health Care Fraud Prevention (Score: -1)
  
  
• Key for participation codes:
• Sponsorships: p=sponsored; o=co-sponsored; s=signed
• Memberships: c=chair; m=member; e=endorsed; f=profiled; s=scored
• Resolutions: i=introduced; w=wrote; a=adopted
• Cases: w=wrote; j=joined; d=dissented; c=concurred
• Surveys: '+' supports; '-' opposes.