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S. Rept. 114-104 1 (2015-07-30)

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                                                       Calendar No. 183
                  114TH CONGRESS                                    REPORT
                     1st Session             SENATE                 114-104





                   PREVENTING AND REDUCING IMPROPER MEDICARE AND
                        MEDICAID   EXPENDITURES (PRIME) ACT OF 2015


                                   JULY 30, 2015.-Ordered to be printed


                             Mr. HATCH, from the Committee on Finance,
                                      submitted the following


                                         REPORT

                                         [To accompany S. 861]
                    The  Committee on  Finance, to which was referred the bill (S.
                  861) to amend  titles XVIII and XIX of the Social Security Act to
                  curb waste, fraud, and abuse in the Medicare and Medicaid pro-
                  grams, having considered the same, reports favorably thereon with
                  an amendment  and recommends  that the bill, as amended, do pass.
                                I. LEGISLATIVE BACKGROUND
                    The  Committee on  Finance, to which was referred the bill (S.
                  861) to amend  titles XVIII and XIX of the Social Security Act to
                  curb waste, fraud, and abuse in the Medicare and Medicaid pro-
                  grams,  reports favorably thereon with an amendment  and  rec-
                  ommends  that the bill, as amended, do pass.
                  Background  and need for legislative action
                    The  Medicaid Integrity Program (MIP) was established by the
                  Deficit Reduction Act of 2005 to support and enhance program in-
                  tegrity efforts, by sustaining and expanding national oversight ac-
                  tivities such as provider audits, overpayment identification and
                  payment  integrity and quality of care education. This bill enhances
                  MIP  by providing the Secretary of Health and Human   Services
                  (HHS)  the flexibility to appropriately resource oversight activities;
                  improving financial incentives for oversight contractors to encour-
                  age appropriate activities and goals; imposing stronger penalties
                  against individuals who commit  fraud; and strengthening data-
                  sharing initiatives in the Medicare and Medicaid programs to bet-
                  ter identify patterns of fraud, waste, and abuse.
                     49-010

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