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CONGRESSIONAL RECORD— Extensions Of E1952 CONGRESSIONAL RECORD Ð Extensions of Remarks October 7, 1997 renowned author, a distinguished civic leader, A recent audit by the Health and Human FINANCIAL AND COMPLIANCE AUDITS SHOULD BE A COST and an outspoken champion of the rights of Services Office of Inspector General [HHS OF DOING BUSINESS WITH MEDICARE AND MEDICAID District residents. OIG] estimated that approximately $23 bil- I want to highlight one particular provision in I rise to recognize Pastor Hicks on the occa- lionÐabout 14 percent of the total Medicare this billÐthe use of compliance and financial sion of the Metropolitan Baptist Church's 20th fee-for-service benefit paymentsÐhad been audits. Unfortunately, it's relatively easy for Pastoral Jubilee for their pastor, when the improperly paid through the Medicare system. fraudulent operators to escape detection be- more than 7,000 members of the church are These errors included everything from simple cause the Health Care Financing Administra- celebrating his many accomplishments and mistakes to outright fraud. Most improper pay- tion [HCFA], which oversees the Medicare and contributions. Pastor Hicks has been a leader ments were due to the lack of any or ade- Medicaid Programs, is woefully lacking in re- in bringing women into the ministry and has quate documentation to support the claimed sources to provide adequate oversight and to advocated the ordination of women. He has serviceÐlack of medical necessity; incorrect track down abusers. Over the past 7 years, established programs at the church that are coding; and noncovered or unallowable serv- the number of Medicare claims processed much-praised models for churches around the ices. All the money improperly paid, however, rose 70 percent, while HCFA's budget for re- Nation for people living with AIDS and their was wasteful. viewing claims grew less than 11 percent. Ad- families, for prison inmates, for seniors, and RECENT LEGISLATIVE EFFORTS ARE PROMISING BUT NOT justing for claims growth and inflation, funding for youth. He has rebuilt his historic church ENOUGH for review dropped from 74 cents to 48 cents and made it a center for revitalization of its We should be proud of recent legislative ef- per claim. As a result, the proportion of claims inner city neighborhood. forts. The Health Insurance Portability and Ac- reviewed dropped from 17 percent to 9 per- Dr. Hicks has become a leading voice in cent. In the especially problematic home pursuing the democratic right of self govern- countability Act and the Balanced Budget Act of 1997 made significant strides in combating health area, reviews plummeted from 62 per- ment for District residents. When the Con- cent in 1987 to a target of 3 percent in 1996. gress forced a death penalty referendum on fraud, waste, and abuse in the Medicare and Medicaid Programs. With bipartisan coopera- In many industries, it is standard operating the District in 1992, Dr.Hicks was chair of the procedure for businesses to fund independent campaign against the death penalty. He led tion, we enacted unprecedented tools for fight- ing what has become one of the favorite audits of their compliance with Federal laws the campaign not only as a civic leader of the and regulations. For example, banks have community, but also as a minister of the Gos- crimes of the 1990'sÐcheating the Govern- ment of billions of dollars through health care paid for independent government financial and pel who, like many of the ministers in the Dis- compliance audits since the 1800's. In fact, trict, opposes the death penalty on religious fraud. This new legislation designs a fraud fighting program that coordinates the efforts of the Office of the Comptroller of the Currency grounds. is a special branch of the Treasury Depart- Dr. Hicks' dissertation for his doctoral de- a broad array of law enforcement and health care agencies. Equally as important, it author- ment that is fully funded through fees it as- gree from Colgate Rochester Divinity School sesses for conducting bank audits. It's time we in 1972, ``Images of the Black Preacher: The izes funding to support the work of law en- forcement and the development of new detec- do the same for providers and suppliers who Man Nobody Knows,'' was published in 1977. do business with the Medicare and Medicaid Since then he has been widely published in tion and enforcement techniques. Total fines, restitutions and recoveries programs. religious publications. His two most recent vol- Health care spending consumes an ever-in- achieved this year from OIG criminal and civil umes are ``Preaching Through a Storm'' and creasing portion of the Federal budgetÐnow investigations totaled $1.2 billion. This is five ``Correspondence with a Cripple From Tar- at least 20 percent. And the Federal Govern- times higher than recoveries for fiscal year sus.'' ment pays a third of our Nation's health care In recognition of his extraordinary talent in 1996. Approximately 2,500 health care provid- billsÐmore than any other single source. We his calling, Ebony named Dr. Hicks one of the ers and entities were excluded from doing are the largest purchaserÐisn't it time we be- ``Fifteen Greatest African-American Preachers'' business with the Medicare, Medicaid, and come a wiser purchaser? And isn't it impera- in 1993. Mr. Speaker, I ask that Members of other Federal and State health care programs tive that we have tighter reins on an area that this body, the U.S. House of Representatives, because of violations of the lawÐan 80-per- consumes so many of our tax dollars? join me in saluting the dynamic leadership of cent increase from the 1,400 exclusions in fis- Banks have for many decades borne the fi- Rev. Dr. H. Beecher Hicks, Jr. cal year 1996. nancial responsibility for demonstrating their f Although we're heading in the right direc- legitimacy. It is an accepted cost of the privi- tion, massive fraud schemes to defraud the MEDICARE AND MEDICAID BENE- lege of keeping other people's money. Medi- Government continue. Here are just a few ex- FICIARY PROTECTION ACT OF care and Medicaid providers are being given amples. 1997 the privilege of taking taxpayers' money, with- A psychologist billed for more than 24 hours out the corresponding responsibility for proving HON. FORTNEY PETE STARK of therapy in a single day. their legitimacy. The appalling level of fraud, A home health agency charged for visits to waste and abuse in the programs is the unfor- OF CALIFORNIA patients' homes when the patients were actu- IN THE HOUSE OF REPRESENTATIVES tunate result. ally hospitalized. HHS doesn't have the funding to audit all Tuesday, October 7, 1997 A nursing home submitted claims for sur- categories of providers that have abusive track Mr. STARK. Mr. Speaker, today I am intro- gical dressings on behalf of patients who had records. Even if it did, taxpayers shouldn't ducing the Medicare and Medicaid Beneficiary not undergone surgery. have to foot the bill. Twenty three billion dol- Protection Act of 1997, a bill designed to con- A fictitious diagnostic firm collected payment lars says it's time to make Federal audits a tinue our fight against health care fraud, for nonexistent lab work on dead people. cost of doing business with the Nation's larg- waste, and abuse in the Medicare and Medic- One beneficiary was charged $5,290 for est health care payer, the Federal Govern- aid Programs. tape over a 6-month period of which $5,000 ment. THE PROBLEM was excessive. Medicare paid for but the ben- WE SHOULD BE DILIGENT IN OUR FIGHT AGAINST HEALTH The General Accounting Office [GAO] has eficiary probably did not receive, 66,000 feet CARE FRAUD estimated that fraud and abuse could be as or 12.5 miles of 1-inch tape. It's simple for meÐindividuals found to in- much as 10 percent of total health care Although recent legislation is a good first tentionally, systematically and repeatedly de- spending. This best estimateÐthat 10 percent step, we need to do more. In a August 19, fraud Medicare and Medicaid should go to jail. of the Nation's $1 trillion health bill is lost in 1997, statement, Gregory Anderson, director We should have a zero tolerance for repeat waste, fraud, and abuseÐincludes both the of corporate and financial investigations for offenders. We should not hide behind free private and public sector. Consider this . Blue Cross and Blue Shield of Michigan said market language as an excuse for criminal be- Federal baseline outlays for Medicare are ap- it bestÐdespite increased enforcement and havior. The fight against health care fraud proximately $208 billion in fiscal year 1998Ð the publicity of million dollar settlements with should be aggressive and on-going. Medicare and 10 percent of waste, fraud, and abuse large, multi-State health corporations, ``the re- beneficiaries deserve the best we can offerÐ roughly equals the $23 billion we cut each wards outweigh the risks today.'' quality care at an affordable price with strong year in this year's budget reconciliation bill. If The bill I am introducing today aggressively protections against unscrupulous providers. we were tougher on health care fraud, we continues the fight. My message should be The following is a summary of the bill: wouldn't have to cut payments from the hon- clear to those who do business with Medicare I. Title IÐRevisions to Sanctions for Fraud est, hardworking providers who justly should and MedicaidÐthe fight against health care and Abuse receive payment for their services. fraud is just beginning. A. Subtitle AÐExclusion Authority October 7, 1997 CONGRESSIONAL RECORD Ð Extensions of Remarks E1953 1. Sec. 101ÐClarifies the application of 1. Sec. 301ÐFees for agreements with ing.
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