The Medicare and Medicaid Fraud Prevention bill has been co-introduced by 8th Congressional District Representative Gabe Evans and Democratic Representative Scott Peters from California. The bill calls upon states to regularly check the Social Security Administration death file to identify deceased physicians. The press release states that hackers can utilize a deceased physician's National Provider Identifier to commit fraud.
The bill comes as the Trump administration and the Department of Government Efficiency have raised alarms regarding improper payments within government agencies, including Medicare and Medicaid. The Government Accountability Office released a report showing $54.3 billion in improper and unknown payments in 2024 and Medicaid had $31.1 billion in improper or unknown payments. Medicare and Medicaid accounted for 53 percent of the total improper and unknown payments tracked by GAO in 2024.
“We must eliminate and be proactive against fraud within Medicaid and Medicare to protect the programs for those who truly need it,” Congressman Evans said. “I’m proud to co-lead the bipartisan Medicare and Medicaid Fraud Prevention Act to advocate for access to quality health care for Americans who rely on these programs.”
A report from The U.S. Department of Health and Human Services’ Office of the Inspector General (OIG) estimated that Colorado paid $7.3 million to insurance companies for care of Medicaid recipients who were deceased. Insurance companies were paid on behalf of approximately 9,000 deceased Medicaid recipients. $3.8 million in improper payments were made with federal funds and Colorado may be expected to pay that back.
The Colorado Department of Health Care Policy and Financing spokesperson Marc Williams said the OIG’s approach to calculate the improper financial payments was inadequate. Williams said the OIG did not reach out to the recipients to verify they had died and that the state has no intention of paying back the money to the federal government.
“Fraud in Medicare and Medicaid hurts the rightful beneficiaries of those programs and all taxpayers,” Representative Peters said. “Our bipartisan bill will prevent one of the most egregious forms of fraud in our healthcare system. As we work to put our country on a better fiscal path and tackle our enormous debt, we must do everything we can to stop taxpayer dollars from being misspent.”
