The Health Care Policy Blog is a forum for health care policy professionals and Bloomberg BNA editors to share ideas, raise issues, and network with colleagues.
Tuesday, June 11, 2013
by James Swann
A bipartisan bill introduced June 10 in the Senate and House would strengthen penalties for medical identity theft and penalize Medicare and Medicaid contractors for excessive error and overpayment rates. The Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2013, or PRIME Act, was introduced in the Senate by Security and Governmental Affairs Committee Chairman Tom Carper (D-Del.) and Ranking Member Tom Coburn (R-Okla.), and in the House by Reps. Peter Roskam (R-Ill.) and John Carney (D-Del.).
Penalties for purchasing or selling a stolen Medicare or Medicaid beneficiary number would result in no more than 10 years in prison or no more than a $500,000 fine, or both, according to the bill. As for the contractor penalties, "they shall include substantial reductions in award fee payments under award fee contracts for any Medicare Administrative Contractor that reaches an upper end error threshold or other threshold as determined by the Secretary," the bill said.
Additional provisions would expand the Senior Medicare Patrol into the Medicaid program as well as improve data sharing between the federal government and state Medicaid programs. The Senate bill, S. 1123, was referred June 10 to the Senate Finance Committee, while a companion bill in the House, H.R. 2305, was referred to the Committee on Energy and Commerce and the Committee on Ways and Means.
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