[Congressional Record Volume 155, Number 154 (Thursday, October 22, 2009)]
[Senate]
[Pages S10703-S10704]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. SPECTER (for himself and Mr. Graham):
  S. 1843. A bill to provide increased penalties for health care fraud; 
to the Committee on the Judiciary.
  Mr. SPECTER. Mr. President, I have sought recognition to speak about 
the Strengthening Enforcement for Health Care Fraud Crimes Act of 2009, 
which I am introducing today with Senator Graham.
  At a time when Congress is poised to pass historic health care reform 
legislation to protect the health of Americans, it is imperative that 
we do all that we can to eliminate waste, fraud and abuse in America's 
health care systems. We must do all that we can to prevent, detect and 
vigorously prosecute health care fraud.
  Health care fraud costs tax payers billions of dollars each year. 
National health care spending in the United States exceeded $2.2 
trillion and represented 16 percent of the Nation's Gross Domestic 
Product in 2007. The National Health Care Anti-Fraud Association, 
NHCAA, conservatively estimates that 3 percent of all health care 
spending--or more than $60 billion--is lost to health care fraud 
perpetrated against both public and private health plans. Other 
estimates by government and law enforcement agencies suggest losses 
from fraud as high as 10 percent--or $220 billion annually.
  Fraud committed against both public and private plans by health care 
providers, medical equipment suppliers, drug companies, and also by 
fraudulent plan operators and brokers, undermines public trust in our 
health care system.
  More importantly, the costs of health care fraud are borne by all 
Americans. It does not matter if you have health insurance sponsored by 
your employer, if you purchase privately your own insurance policy, or 
pay taxes to fund government health care programs. Health care fraud 
results in reduced benefits and coverage, and higher premiums and 
costs. It can mean higher taxes and increased budgetary challenges.
  Health care fraud often targets the most vulnerable in our society--
the elderly, the poor, and the infirm. Criminals involved in health 
care fraud falsify patients' medical records and steal patients' 
personal and insurance information to submit fraudulent claims. Health 
care fraud subjects patients to unnecessary and dangerous medical 
procedures. According to the FBI:

       One of the most significant trends observed in recent 
     health care fraud cases includes the willingness of medical 
     professionals to risk patient harm in their schemes. FBI 
     investigations in several offices are focusing on subjects 
     who conduct unnecessary surgeries, prescribe dangerous drugs 
     without medical necessity, and engage in abusive or sub-
     standard care practices.

  FBI Financial Crimes Report to the Public, Fiscal year 2007.
  Criminologists have long reported that criminals look at three 
factors in performing their own cost benefit analysis: the risk of 
getting caught; the probability of being convicted; and the severity of 
the punishment.
  The bill I am introducing today addresses the third factor--and sends 
the message loud and clear to those who would contemplate committing 
health

[[Page S10704]]

care fraud. If caught stealing $100,000 or more you will go to jail--no 
ifs, ands or buts. The bill provides a sentence of at least 6 months 
incarceration for committing health care fraud with losses of $100,000 
or more. You may even get more jail--under the discretionary 
guidelines--but no one will get less than 6 months for schemes of this 
size.
  Since the Supreme Court decided United States v. Booker in January 
2005 and made the Sentencing Guidelines advisory, sentencing judges 
have wide discretion to impose sentences on criminal defendants unless 
mandatory minimum sentences are applicable. Except for aggravated 
identity theft crimes, defendants do not face mandatory imprisonment 
for white collar crimes. Given the importance and necessity to 
vigorously prosecute and punish serious health care fraud crimes, I 
urge the Senate to pass this bill. Without it, there will be no 
certainty of punishment nor effective deterrence for serious health 
care fraud crimes.
                                 ______