Ways and Means Committee backs anti-fraud measures after U.S. health care crackdown

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Ways & Means anti-fraud measures

Highlights

House Ways and Means Committee, led by Jason Smith, advances legislation to combat fraud in Medicare, durable medical equipment, unemployment insurance, and TANF programs.
New measures include in-person inspections of hospice and home health providers, higher penalties for data submission failures, and faster reimbursement to enhance fraud detection.
Proposed safeguards aim to address Medicare fraud estimated at $60 billion annually and improve recovery of nearly $1 billion in fraudulent pandemic-era unemployment benefits.

Committee cites enforcement action and pending safeguards

As reported by the House Committee on Ways and Means, Chairman Jason Smith says the Trump Administration’s health care fraud takedown highlights the need for Congress to strengthen protections for taxpayers and program beneficiaries.

Smith says the administration is showing an aggressive approach to waste, fraud and abuse, and describes the latest enforcement action as part of an ongoing effort to stop individuals and companies from exploiting federal benefit systems. He also says Congress plans to keep working with the administration on measures aimed at preventing future losses across health care and welfare programs.

The committee says it has already held multiple hearings and advanced legislation covering fraud in Medicare home health and hospice programs, the durable medical equipment payment system, COVID-era unemployment insurance and the Temporary Assistance for Needy Families program.

Health and welfare programs face wider oversight push

At an April hearing focused on Medicare fraud, which Smith says costs taxpayers $60 billion each year, lawmakers heard testimony describing fraudulent hospice providers allegedly operating from locations including a burrito stand and a tire store in California. Another witness testified that her Medicare benefits had been stolen, leading to denied physical therapy claims after she was falsely classified as a hospice patient.

Measures advanced by the committee include more in-person inspections to verify hospice and home health providers, higher penalties for failing to submit quality data, and faster reimbursement submissions from durable medical equipment suppliers to improve fraud detection. The package also calls for tighter federal scrutiny of state use of TANF funds, better coordination with financial institutions to recover nearly $1 billion in frozen fraudulent pandemic-era unemployment benefits, and a longer statute of limitations for prosecuting unemployment fraud.

In our earlier report on the Ratepayer Protection Act, we covered how lawmakers want to shift the cost of grid upgrades required by fast-growing AI data centers away from households and small businesses. The article explained that the proposal would require utilities to apply large-load standards and push data center developers to pay for related generation and transmission investments as the bill moves through Congress.

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