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North Carolina Members of Congress Urged to Close Medicare Loopholes

Photo: Supporters say PRIME Act could further reduce Medicare fraud. Courtesy: medicare.gov
Photo: Supporters say PRIME Act could further reduce Medicare fraud. Courtesy: medicare.gov
July 25, 2013

RALEIGH, N.C. - North Carolina members of Congress are being urged by organizations such as AARP to close Medicare loopholes, which would help cut costs without cutting benefits. So far, none have stepped up to support the so-called PRIME (Preventing and Reducing Improper Medicare and Medicaid Expenditures) Act.

Existing efforts to curb fraud and abuse already put seven dollars back into the Medicare program for every dollar spent, according to Larry McNeely, policy director, National Coalition on Health Care, who supports the legislation.

"Why don't we do more to go after either the real, actual fraud or the waste in that system?" he asked. "This actually takes a laser and really tries to make efforts to stop fraud in Medicare a lot more effective."

The bill focuses on prevention: Stop improper payments instead of trying to collect the money after it's paid out, make it harder to steal the identities of physicians and reward patients who help Medicare identify fraud. The PRIME Act is proposed in both the House and the Senate. McNeely said although bipartisan support is growing, the Act has not yet been assigned to a committee.

McNeely acknowledged that cutting fraud is not always the easiest thing to do, but said lawmakers have an obligation to protect Medicare benefits.

"We're paying for the volume of health care, not the value of health care. If we do both those things - go after the fraud and then go after the waste - there's a real avenue to bring down costs in Medicare without harming beneficiaries," he said.

AARP North Carolina estimates that improper payments may account for as much as 10 percent of Medicare spending, which totaled more than $600 billion a year, last year.

More information on the PRIME Act is available at http://blog.aarp.org.

Stephanie Carroll Carson, Public News Service - NC