Doggett Opening Statement at Full Committee Hearing on Protecting Patients and Taxpayers: Cracking Down on Medicare Fraud
(As prepared for delivery)
A hearing in this Committee on health care fraud is years overdue, though tough talk is certainly no substitute for effective law enforcement. Thanks to those witnesses today, who have been working to detect and report fraud—your efforts are all the more important because of how little the Trump regime and this Congress have done, instead coddling the criminals.
Following last week’s pitiful performance by Secretary Kennedy with his complete inability to answer any of my questions concerning his reinstatement of 850 agents and brokers, who had been suspended by the Biden Administration for suspected fraud, I once again renewed my written request to CMS Administrator Dr. Oz requesting an overdue answer to my December inquiry about this soft on fraud approach—a request once again met with silence. Both RFK and Oz are unable to confirm whether these brokers were even investigated or monitored after sudden reinstatement.
Let me be clear about the significance of this lack of accountability. On December 3, the Government Accountability Office responded to a joint request from Chair Smith and Budget Chair Arrington. They declared the GAO report “a smoking gun” showing extensive fraud in the Affordable Care Act Marketplace—so much fraud that they claimed justification for terminating premium tax credits—an action which is now costing millions of Americans access to a physician.
Yet, the fraud was not committed by some mother desperate to get care for a sick child. No, all the fraud was perpetrated by agents and brokers, who illegally enrolled people into health coverage without their knowledge. And this Committee has yet to do a thing. It seems to have adopted the same permissive approach toward health care fraud that it has so consistently shown to tax fraud.
Meanwhile, President Trump continues his soft on crime approach toward fraud by the wealthy and powerful. He has pardoned more fraudsters than any president in U.S. history—allowing the criminals to walk free and denying their victims millions in restitution.
The Chair refused to hold a single hearing on the GAO report before he took the knee jerk action of ending the ACA premium tax credits, but I am pleased we are having this long overdue hearing that I first requested of the Chair three years ago on March 28, 2023 following a meeting to discuss health priorities. After subsequent written requests over two Congresses, this Committee is finally showing some interest in addressing waste, fraud and abuse rather than using it as a watchword. I hope this will be more than the performative actions of the Trump regime.
After Mr. Musk and the DOGE initiative fell short in tackling fraud last year, ultimately, probably costing more than it saved, President Trump has now assigned responsibility to Vice President Vance. Previously, the Trump approach was pardon the health care criminals, fire the taxpayer watchdogs who detect and prevent fraud, and cut the essential programs upon which millions of Americans rely. Outrageously, when anti-fraud provisions run up against a special interest with a generous lobbyist, the anti-fraud provisions usually lose along with consumers and taxpayers.
There are reasonable solutions to stop fraud. Instead of hiring AI companies to add prior authorization requirements to Traditional Medicare that will delay and deny care for consumers, let’s use that technology to detect when the same Social Security Number is fraudulently used to enroll someone into 125 health care plans at once, as the GAO exposed in its broker fraud report.
Let’s ensure CMS has the full scope of authority to prevent fraud, and actually uses its authority. One modest example is my legislation to permit CMS to deactivate National Provider Identifier numbers for convicted fraudsters so they can’t bill Medicare again.
I look forward to our witnesses’ testimony with additional solutions.
I also ask unanimous consent to enter into the record my correspondence with the Chair concerning a fraud hearing, my correspondence with Administrator Dr. Oz concerning broker fraud, the Chair’s joint release reacting to the GAO’s report, and a new report from Protect Our Care concerning the Trump regime’s soft on crime approach to fraud.
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