[Congressional Record Volume 142, Number 86 (Wednesday, June 12, 1996)]
[Senate]
[Pages S6115-S6116]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                    CONGRATULATIONS TO SENATOR LOTT

  Mr. COHEN. Mr. President, let me first add my congratulations to the 
new majority leader. I think that Trent Lott will do an outstanding job 
and one that will certainly make our party proud, but the country proud 
as well. I was pleased to have his colleague, Thad Cochran, with whom 
we both entered Congress, stand up in a true southern fashion, extend 
his warmest wishes and willingness to work with you. It will be a great 
team from Mississippi and for the rest of the country. I add my 
accolades to you, Mr. Leader.

[[Page S6116]]



                      HEALTH CARE FRAUD AND ABUSE

  Mr. COHEN. I want to take a few moments to talk about something that 
is of great importance to me. As is so often the case in Washington, 
misinformation is flying about the effects of legislation being 
considered in Congress. It is customary in this country and in this 
Congress, to have, just as we are negotiating the last-minute details 
to legislation, some interest group come forward, place a provocative 
ad in the newspaper, and try to destroy that legislation.
  I am referring to the fraud and abuse provisions in the Kennedy-
Kassebaum health care legislation that is now in the final stages of a 
conference. Recently, the American Medical Association placed a full-
page ad in the Wall Street Journal. The ads are slick and very clever--
it shows a doctor, with a stethoscope hanging down, in the ``docks.'' 
It says, ``We (the AMA) are opposed to fraud and abuse. We know it is a 
serious problem, but if doctors willfully and knowingly violate our 
Nation's laws, they should be punished.''
  Mr. President, this is precisely what the legislation does. Then the 
ad goes on to say, ``But honest mistakes should not make physicians or 
any other citizens candidates for incarceration.'' We agree.
  This legislation has been worked on for the past 3 years. As a matter 
of fact, this particular ad is not only misleading, it is false. It is 
absolutely false advertising that the AMA has engaged in, along with 
other physician groups who have written articles.
  To distort the intent and scope of the provisions in this fashion 
minimizes the very real threat that fraud poses to our health care 
system and, indeed, to the solvency of Medicare. Medicare trustees have 
said the trust fund is going broke--not in 6 years--but in 5 years. One 
of the reasons it is going broke is because so much fraud and abuse is 
being perpetrated on the American people. As we are asking Medicare 
beneficiaries and honest providers to share the burden of changes to 
arrest the growth of Medicare, it is our duty to do all we can to get 
the waste, fraud, and abuse out the program.
  According to the General Accounting Office, we are now losing as much 
as $100 billion from fraud and abuse every year. The losses to Federal 
health care programs, such as Medicare, Medicaid, and CHAMPUS, is about 
$40 billion or 40 percent of the total.
  Mr. President, it is a grand scale of theft that is taking place. We 
have heard testimony that organized crime has moved into health care 
fraud. We heard testimony that drug dealers have moved into health care 
fraud because there is more money and it is easier for them to 
perpetrate this crime rather than trying to sell drugs with the FBI 
breathing down their neck. As Willie Sutton said, ``that's where the 
money is.''
  Let me give you a couple of examples that have come to my attention. 
I have had hearing after hearing on this subject matter. Seven months 
ago, a physician testified before the Senate about his involvement in a 
clinic scam in Los Angeles. The physician participated in a scheme that 
involved phony prescriptions, paid patients, and resulted in losses 
over $800,000 to the Medicaid Program.

  In another case, the owner of a home health care company built a 
beautiful $2.5 million mansion with money he made from phony Medicare 
billings.
  A New York physician defrauded the Medicaid Program of more than $1.5 
million by fraudulently charging for 25,000 drug treatments never given 
to recipients.
  We have even heard of a case where a psychiatrist billed for 50,000 
phantom therapy sessions never given to patients.
  That is just a small sample of what we are trying to deal with today. 
And that is why we passed this important legislation by overwhelming 
numbers in this body.
  The health care fraud provisions now being considered by the Senate 
and House conference committee do address this problem in a reasonable, 
measured manner that does not infringe on personal liberties nor 
penalize innocent mistakes. The bill closes loopholes in current law 
and provides criminal penalties for a defined set of serious and 
egregious violations such as embezzlement. The fraud and abuse 
provisions substantially mirror existing fraud statutes and are 
designed to give enforcement more precise tools to protect consumers 
against fraud and abuse. Contrary to claims that the bill will unleash 
an army of intrusive investigators trying to entrap innocent doctors, 
the proposal simply provides adequate resources for prosecutors and 
investigators, long strapped by budget cuts and under staffing to go 
after serious patterns and cases of abuse.
  The AMA's claim that ``honest mistakes'' of doctors or any other 
citizens makes them ``candidates for incarceration'' is simply false. 
Far from going after honest mistakes, the criminal sanctions will be 
used to prosecute egregious, intentional acts of fraud against health 
plans.
  Mr. President, the final thrust of the attack ads that are being 
leveled against this legislation is that this is Clinton's health care 
plan revisited. That, too, is absolutely false. This legislation was 
developed in response to the recommendations put forth by a task force 
put together by President Bush, which was headed by a Justice 
Department that was dominated at the top level by President Bush 
appointees. It has been endorsed by Bob Dole, our former majority 
leader, and virtually everybody in our leadership for many years. These 
provisions have passed twice before during this Republican-controlled 
Congress and have been the subject of numerous hearings in both the 
Senate and House. The notion that somehow this is Clinton II slipping 
through the cracks at the last moment is completely false.
  We have to deal with health care fraud in a direct and responsible 
fashion. The legislation we passed by an overwhelming majority in this 
body, unanimously, as I recall, deserves not to be undercut by false 
and misleading advertising. I hope my colleagues reject these kinds of 
last-minute scare tactics which the AMA and others are engaged in. The 
only ones to gain from failing to pass this antifraud package are those 
who are intentionally ripping off the system. All the rest of us are 
the big losers--the vast majority of honest health care providers, 
taxpayers, and families who are footing the bill for the fraudulent 
providers in the form of higher taxes and health care costs.
  Mrs. FEINSTEIN addressed the Chair.
  The PRESIDING OFFICER. The Senator from California.
  (The remarks of Mrs. Feinstein pertaining to the introduction of S. 
1865 are located in today's Record under ``Statements on Introduced 
Bills and Joint Resolutions.'')
  Mrs. FEINSTEIN. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mrs. FEINSTEIN. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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