[Congressional Record Volume 145, Number 135 (Thursday, October 7, 1999)]
[Extensions of Remarks]
[Page E2069]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                   THE SENIOR CITIZENS PROTECTION ACT

                                 ______
                                 

                            HON. RICK LAZIO

                              of new york

                    in the house of representatives

                       Thursday, October 7, 1999

  Mr. LAZIO. Mr. Speaker, I rise today to introduce a bill to cut fraud 
and abuse in our Medicare system, restore balance in our health care 
system, and give us all a better quality of life. Federal, state, and 
local governments need more tools at their disposal to crack down on 
rampant health care fraud. Congress needs to empower law enforcement to 
preserve and protect Medicare, decrease the crime rate, and let each 
and every one of us feel safe and secure in our retirement years.
  The Health and Human Services' Office of the Inspector General 
recently released startling information on their audit of the Health 
Care Financing Administration (HCFA). According to the audit, the 
Medicare Program lost $20 billion in fraud and improper payments in 
Fiscal Year 1997. What is unconscionable is that only $4 billion was 
recovered.
  A recently published Focus Group Study of Medicare Insurance 
Counselors found that most officials believe a significant amount of 
fraud exists and continues to undermine the Medicare program. In the 
study, many experts said HCFA took no action after being notified of 
fraud. The May 1998 study further cited that HCFA did not have adequate 
systems and procedures in place to root out fraud.
  A major reason health care fraud is at historic levels is because 
current law bars state officials from even investigating Medicare 
fraud. They are limited to investigating suspected fraud in the 
Medicaid. This creates an enforcement gap because an entity defrauding 
Medicaid is often linked to fraud in other federal health programs.
  An example from my district on Long Island illustrates this 
predicament perfectly. A provider was suspected of defrauding Medicaid. 
The state and its Medicaid Fraud Control Unit began an investigation. 
That investigation spilled over into allegations of Medicare fraud and 
the state could not investigate because it lacked the requisite 
authority. Despite repeated requests from the state, the Federal 
Government did not investigate or prosecute the allegations. While the 
state was trying to wrest control of the investigation for the Federal 
Government, the provider billed nearly $2 million. If the state had the 
power to investigate, some fraud could have been stopped and stolen 
money would have been recovered and returned to the government coffers.
  My bill, the Senior Citizens Protection Act of 1999, will empower the 
states and their Medicaid Fraud Control Units by allowing them to 
investigate Medicare fraud cases when Medicaid fraud has been alleged.
  A second reason health care fraud remains unchecked is because 
current law prohibits states from investigating patient abuse in 
assisted living and residential-care facilities. Currently, a state 
only has the authority to investigate patient abuse in facilities that 
receive Medicaid reimbursement, usually nursing facilities. Yet today, 
more and more of our friends and family reside in assisted living and 
other residential-care facilities. Normally, federal and local 
governments do not investigate suspected patient abuse in these non-
traditional health care facilities and the state lacks the power to 
delve into these cases. The result is a high number of cases falling 
through the cracks.
  My bill would authorize the states and the Medicaid Fraud Control 
Units to investigate these patient abuse cases in long-term care 
facilities.
  The government should be doing more--much more--to combat fraud and 
abuse. ``White collar'' crimes in the health care industry can be 
stopped. The Senior Citizens Protection Act requires coordination of 
anti-fraud efforts, keeps our senior citizens safe, returns all 
recoveries to the Federal Government, and does not cost the Federal 
Government anything.
  Our government should be given all the tools necessary to combat 
fraud in our health care system and give Americans the peace of mind 
that their moms and dads are well cared for in their retirement years. 
We need to ferret out providers who rip off the system, and Americans 
need to rest comfortably at night knowing our family members and 
friends receive the highest quality health care without the fear of 
being physically, mentally, or financially abused. I urge my colleagues 
to support the Senior Citizens Protection Act of 1999 because it will 
provide health care security to our seniors and restore their trust in 
the people who care for them from morning until night.

                          ____________________