[Congressional Record Volume 143, Number 1 (Tuesday, January 7, 1997)]
[Extensions of Remarks]
[Page E5]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




      THE INSPECTOR GENERAL FOR MEDICARE AND MEDICAID ACT OF 1997

                                 ______
                                 

                            HON. JACK QUINN

                              of new york

                    in the house of representatives

                        Tuesday, January 7, 1997

  Mr. QUINN. Mr. Speaker, I rise today to introduce the Inspector 
General For Medicare and Medicaid Act of 1997.
  I was prompted to introduce this legislation when seniors in western 
New York continuously approached me at my town meetings last year with 
concerns about this issue. Many of us in Congress and throughout the 
country share their concerns that waste, fraud, and abuse within 
Medicare and Medicaid Programs have reached an excessive level which 
threatens the financial stability of our most vulnerable populations.
  For instance, one of my constituents gave me copies of his personal 
medical statements which showed that he was billed three times for the 
same procedure, amounting to $2,367 in charges. Most people do not 
scrutinize their medical statements; which helps for fraud to be easily 
overlooked. in the end, seniors are forced to dip into their life 
savings.
  My bill would establish an exclusive, full-time and independent 
Office of Inspector General [IG] for the Medicare and Medicaid 
Programs. This office would be charged with detecting, identifying and 
preventing waste, fraud and abuse within the Medicare and Medicaid 
Programs.
  This IG office would be required to issue semiannual reports to 
Congress consisting of recommendations on preventing waste, fraud and 
abuse within the Medicare and Medicaid Programs.
  The IG office would also be responsible for coordinating any audits, 
investigations, and other activities which promote efficiency in the 
administration of the Medicare and Medicaid Programs.
  The need for this legislation comes down to dollars and cents. 
According to a 1995 GAO report, unchecked and improper billing alone 
would cost Medicare in excess of $3 billion over the next 5 years. 
Furthermore, health fraud has been estimated to cost between 3 and 10 
percent of every $1 used to meet the health needs of America's seniors 
and indigent populations. I think you would agree that this funding 
would be better spent as a reinvestment in providing healthcare to our 
Nation's elderly, disabled, and poor citizens.
  To further compound the problem, GAO also reported that physicians, 
suppliers, and medical laboratories have about 3 chances out of 1,000 
of having Medicare audit their billing practices in any given year.
  At the conclusion of the July 1995 GAO report to Congress, one of the 
main policy recommendations was to ``enhance Medicare's antifraud and 
abuse efforts.''
  My bill simply responds to this need. I contend that with a separate 
IG office we can only expand on identifying and preventing fraud, 
waste, and abuse in healthcare. Based on HHS data, within a 4-year time 
frame, we have saved $115 for every $1 spent on inspector general 
operations.
  In 1995, the Office of the IG saved $9.7 million per employee. This 
savings was accomplished with employees working on diversified case 
loads. It is my understanding that employees in the IG's office do not 
specialize in Medicare and Medicaid fraud, but must focus on several 
issues at one time. With a more specialized personnel, other HHS 
programs such as welfare and head start stand to benefit as well. By 
magnifying our focus to Medicare and Medicaid fraud, waste, and abuse, 
I am confident that we will see an increased return of our investment.

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