Waste, fraud, and abuse in Medicare is rampant, quite regularly hospitals and healthcare providers routinely overcharge the largest federal healthcare program for services provided for patients. The Recovery Audit Contracts (RAC) program has proven to be extremely effective in identifying and rooting out Medicare fraud, but that doesn’t sit well with the hospital industry, that sees the aggressive rooting out of fraud as cutting into their profit margins. As special interest groups do, they turn bought-and-paid-for politicians in Washington D.C. to give them what they want. In this instance, the American Hospital Association, and other representatives of the major corporate hospital groups, want the RAC program gutted.
Politicians like Reps. Sam Graves (R-MO) and Phil Roe (R-TN), along with more than 100 others members of the House and the Senate, are there to dutifully serve the hospital interests, in gutting the RAC program, against the interest of their constituents back home in their districts. Rep. Graves has sponsored, and Rep. Roe and others co-sponsored, the “Medicare Audit Improvement Act,” which is H.R. 2156 in it’s 2015 form, and H.R. 1250 in its 2013 form. Simply put, this bill would gut the RAC program by severely limiting what percentage of billing could be reviewed by RACs, and placing other limits and restrictions on the program. In short, the bill would enable billions in Medicare fraud, and putting more money into hospitals over-charging Medicare for services provided.
By reviewing just a small fraction of Medicare billing, the RAC program had rooted out $8.9 billion in fraud in just one year, and could easily find an estimated $50 billion Medicare fraud if the program was expanded. Not only did Phil Roe not stand up for taxpayers, and his own constituents by advocating the full expansion of the RAC program, he has stood for shutting it down by sponsoring H.R. 1250 in 2013, the earlier version of the bill, sponsored by Rep. Graves, that would all but eliminate the RAC program.
The American Hospital Association (AHA) has spent $33.8 million in the last couple years in lobbying efforts on Capitol Hill against the RAC program. Additionally, the AHA and other groups representing hospital owning corporations have donated more than $4.1 million to politicians, in an effort to buy their votes for legislation like the Medicare fraud-enabling so-called Medicare Audit Improvement Act. The corrupt politicians receiving this money are the likes of Sam Graves and Phil Roe, who support the legislation to gut the RAC program that is so effective at countering Medicare fraud.
The identifying of who supports this legislation says as much about the cronyism and corruption involved as does those who oppose it. Grass-roots taxpayer advocacy groups like the National Taxpayer Union and Citizens Against Government Waste strongly oppose Rep. Graves’ bill because it’s very much in the interests of taxpayers to strengthen the Medicare program and save taxpayer dollars by rooting out waste, fraud, and abuse. Both organizations have urged Congress to defeat Rep. Graves’ bill. The RAC program could save taxpayers anywhere from $50 to $90 billion in Medicare fraud if fully implemented.
Cong. Phil Roe runs for office on the slogan, “people, not politics.” But his support for legislation gutting the RAC program is all about corrupt politics, and certainly not the interests of his constituents, the people that represents, whose primary interest in this issue saving taxpayer money on Medicare rather than lining the pockets of those who profit from owning huge hospital empires. Rep. Roe sides with his cronies in the healthcare industry that own hospitals, in direct conflicts with the interests of the people of his district. That isn’t doing his job in representing the people, that is serving cronyism and corruption.
It’s no coincidence, given how well Rep. Roe represents hospital interests, that the healthcare industry, by industries, ranks first among industries that donate large sums of money to his campaign fund. Between 2013-2014, they donated money than $85,000 to Phil Roe’s campaigns for reelection. Apparently it’s money well spent for needed favors, given that he over-rides the interests of the taxpayers in rooting out Medicare fraud by co-sponsoring the bill to gut the RAC program.
Politicians like Sam Graves and Phil Roe are best that special interest group money can buy. But the voters in their district should retire them and elect someone to represent them, and not the corrupt special interests, in Washington D.C. Voters need to change who they send to Congress, otherwise we can’t expect anything to change. Government in the nation’s Capitol is broken, and we can only fix it by ending the careers of the corrupt bought-and-paid-for politicians like Graves and Roe.