Proposals will reduce Medicare and Medicaid waste and fraud and provide coordinated health services for nation’s most vulnerable
Jun 24 2015
WASHINGTON – Today, the Senate Finance Committee voted to approve two bipartisan health care proposals supported by U.S. Sen. Mark R. Warner (D-VA) aimed at improving the quality of care for seniors on Medicare. The Committee unanimously voted to approve the Preventing and Reducing Improper Medicare and Medicaid Expenditures (PRIME) Act of 2015 to ensure that seniors receive the health care benefits they have earned by reducing Medicare and Medicaid waste and fraud. The Committee also unanimously passed the Program of All-Inclusive Care for Elderly (PACE) Innovation Act of 2015 to strengthen comprehensive and coordinated health and long-term services for the elderly.
“These bipartisan proposals will not only improve care for seniors and protect some of our nation’s most vulnerable citizens, but save taxpayers money by preventing billions in wasteful and fraudulent Medicare and Medicaid spending,” said Sen. Warner, member of the Senate Finance Committee.
The PACE program – which Sen. Warner has supported since he was Governor of Virginia – provides comprehensive, coordinated health and long-term services and supports for some of our nation’s most vulnerable citizens – individuals 55 or older who qualify for nursing home care. These individuals have been diagnosed with a complex mix of chronic illnesses and functional or cognitive impairments, such as dementia, that inhibit their ability to live independently. For most participants, the comprehensive service package enables them to remain in the community rather than receive care in a nursing home. Financing for the program is capped, which allows providers to deliver all services participants need rather than only those reimbursable under Medicare and Medicaid fee-for-service plans.
The PACE Innovation Act, S. 1362, will expand PACE programs by allowing the Department of Health and Human Services to conduct pilot programs to enable more seniors with chronic conditions to participate.
The PRIME Act, S. 861, would address a series of problems that lead to billions of dollars of waste and fraud in Medicare and Medicaid every year and protects seniors from becoming victims of fraud. To achieve this goal, the PRIME Act would: enact stronger penalties for Medicare and Medicaid fraud; curb improper or mistaken payments made by Medicare and Medicaid; improve the sharing of fraud data across state and federal agencies; phase out the “pay-and-chase” system by establishing stronger fraud and waste prevention strategies, incentivize individual reporting of fraud and abuse; and strengthen the Senior Medicare Patrol to teach more seniors about health care fraud and expand the program to include Medicaid beneficiaries. Its provisions are based on findings and recommendations from the Government Accountability Office, the Health and Human Services Inspector General, and other experts and stakeholders.
Sen. Warner has introduced a series of legislation aimed at fixing Medicare benefits systems to provide comprehensive and long-term health care services for senior citizens. On June 10, Sen. Warner introduced the Care Planning Act, which creates a Medicare benefit for patient-centered care planning for people with serious illness. On Jan. 28, Sen. Warner introduced the Medicare Home Infusion Site of Care Act to allow beneficiaries who need intravenous medications to receive their infusion treatments in the comfort and convenience of their homes and at a lower cost to Medicare. Sen. Warner is also leading a bipartisan effort with his colleague, Sen. Johnny Isakson (R-GA), to improve outcomes for Medicare patients requiring chronic care.