Smucker Introduces Bill to Tackle Medicare Fraud, Stop Improper Payments

WASHINGTON – Rep. Smucker (PA-11), a senior member of the House Ways and Means Committee, introduced the Medicare Payment Integrity Enhancement Act, legislation to prevent Medicare fraud and stop improper payments before they occur.

Under current law, the Centers for Medicare & Medicaid Services (CMS) use Recovery Audit Contractors (RACs) to audit some reimbursements, but they are limited to conducting post-payment reviews. This legislation would direct CMS to authorize the RACs to conduct pre-payment claim reviews to identify fraudulent claims prior to payment. 

Medicare fraud costs more than $60 billion every year. In 2023 alone, HHS estimated that more than $100 billion in improper payments occurred across Mediare and Medicaid.

“Improper payments are a significant driver of government spending, contributing billions of dollars to our national debt every year and weakening programs designed to help Americans. This legislation would help stop waste, fraud, and abuse before it occurs, safeguard taxpayer dollars, address our debt, and improve the benefits millions of Americans rely on. Congress should act without delay to protect taxpayers and strengthen Medicare,” said Smucker.

Organizations supporting the legislation include the National Taxpayer Union, Taxpayers Protection Alliance, and the Committee for a Responsible Federal Budget.

“At a time when the national debt exceeds the size of the economy, and the Hospital Insurance Trust Fund will be exhausted in six years, it is great to see Congressional action to prevent wasteful spending. The RAC program has real potential to reduce improper payments and lower spending in the Medicare program. We applaud Representative Smucker for introducing the Medicare Payment Integrity Enhancement Act and moving us a meaningful step closer toward making Medicare a more efficient steward of taxpayer dollars,” said Maya MacGuineas, president of the Committee for a Responsible Federal Budget.