[Congressional Record Volume 142, Number 46 (Friday, March 29, 1996)]
[Extensions of Remarks]
[Pages E502-E503]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




       HEALTH COVERAGE AVAILABILITY AND AFFORDABILITY ACT OF 1996

                                 ______


                               speech of

                           HON. JENNIFER DUNN

                             of washington

                    in the house of representatives

                        Thursday, March 28, 1996

  Ms. DUNN of Washington. Mr. Speaker, I rise today in strong support 
of the Health Coverage Availability and Affordability Act of 1996. This 
legislation solves the health insurance problems most common among my 
constituents in Washington State--eliminating job lock and preexisting 
conditions while keeping the costs of premiums down.
  A critical component of our efforts to keep the cost of health 
insurance down is the set of provisions to reduce fraud and abuse in 
our Nation's health care system.
  According to the General Accounting Office, each year as much as 10 
percent of our Nation's total health care expenditures are lost to 
fraud and abuse. With annual health care costs in the United States 
approaching $1 trillion, fraud and abuse is robbing taxpayers and 
policyholders of about $100 billion each year.
  Let me repeat that because it is an important fact: fraud and abuse 
is costing our constituents about $100 billion each year.
  Despite the enormity of the problem, the GAO concluded that ``only a 
small fraction of the fraud and abuse committed against the health care 
system is identified.''
  The Department of Health and Human Services has estimated that 
Medicare and Medicaid programs alone lose as much as $31 billion 
annually to fraud and abuse.
  And who pays? Patients, that is who. And in the case of Medicare and 
Medicaid, taxpayers pay for health care fraud and abuse in the form of 
higher health care costs and higher premiums.
  For all these reasons attacking fraud and abuse is an essential 
component of the measure before us today.
  For instance, we get tough on fraudulent and unscrupulous suppliers 
and providers who game the system in order to reap billions of dollars.
  Through the establishment of the Medicare Integrity Program, we 
greatly increase Medicare's ability to prevent payments for fraudulent, 
or erroneous claims, and to identify illegal billing schemes early to 
avoid large losses.
  We provide incentives for individual beneficiaries to report 
fraudulent, abusive, or wasteful claims practices.
  Under the bill, a Health Care Fraud and Abuse Account with the 
Federal hospital trust fund is created. Moneys derived from the newly 
coordinated health care antifraud and abuse programs will be 
transferred into the trust for the expressed purposes of fighting fraud 
and abuse.
  This new funding is vital because there has been a 45-percent drop in 
per claim spending

[[Page E503]]

on Medicare fraud and abuse prevention activities since 1989, despite 
historic savings rates in excess of $10 for every $1 invested in 
prevention. Our plan devotes more resources to the fight against fraud 
and abuse.
  We also toughen criminal laws and enforcement tools for intentional 
fraud and abuse. The lack of a specific Federal health care fraud 
criminal statute, coupled with weak sanctions, has significantly 
hampered law enforcement's efforts to combat health care fraud. That is 
why it is so necessary to create this new criminal offense for 
activities such as theft, embezzlement, false statements, and money 
laundering. We then provide for mandatory forfeiture of property in 
such cases. In addition, civil monetary penalties will be substantially 
increased from $2,000 to $10,000 for each item or service involved. All 
of these efforts will serve to deter future abuses.
  Strengthening prevention, increased funding for the battle against 
fraud and abuse, better coordination and enforcement, new criminal 
fraud statutes--all of these are included in this bill. I urge my 
colleagues to support our effort to end this annual $100 billion rip-
off of taxpayers by supporting the bill.

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