Bipartisan Proposal Aims to Tackle Healthcare Fraud ‘One of the Most Egregious’

A new bipartisan proposal seeks to strike back against fraud in the healthcare sector, specifically targeting Medicare and Medicaid abuse by exploiting Social Security Administration death records.

The legislation, known as the Medicare and Medicaid Fraud Prevention Act, would require state governments to cross-check the Social Security Death Master Files to ensure that doctors listed in these programs are actually alive and practicing. This measure aims to prevent bad actors from misusing a deceased doctor’s National Provider Identifier for fraudulent activities.

Rep. Gabe Evans, R-Colo., one of the bill’s sponsors alongside Rep. Scott Peters, D-Calif., stated, "We must eliminate and be proactive against fraud within Medicaid and Medicare to protect the programs for those who truly need it. I’m proud to co-lead the bipartisan Medicare and Medicaid Fraud Prevention Act to advocate for access to quality health care for Americans who rely on these programs." A noble sentiment, but also, isn’t it just wild that this kind of fraud is even a thing?

This isn’t the first time such legislation has been proposed. A similar bill introduced by former Rep. Mike Garcia, R-Calif., also had bipartisan backing, passing the House before stalling in the Senate Finance Committee last year. Despite its previous roadblock, the urgency to address healthcare fraud remains a pressing issue.

Rep. Peters emphasized the stakes, saying, "Fraud in Medicare and Medicaid hurts the rightful beneficiaries of those programs and all taxpayers. Our bipartisan bill will prevent one of the most egregious forms of fraud in our healthcare system. As we work to put our country on a better fiscal path and tackle our enormous debt, we must do everything we can to stop taxpayer dollars from being misspent." Seems like common sense, right? Yet here we are.

The timing of this renewed push aligns with increased scrutiny of Medicaid programs at both state and federal levels. In Colorado, Rep. Evans’ home state, an audit revealed $7.3 million was paid to insurance companies on behalf of deceased Medicaid recipients. Meanwhile, California is grappling with a ballooning $9.5 billion Medicaid budget—nearly $3.5 billion over its initial projection. Governor Gavin Newsom has acknowledged that allowing illegal immigrants to enroll in Medi-Cal is a contributing factor but maintains that California’s rising costs are comparable to other states like Colorado, Pennsylvania, and Indiana.

According to the Government Accountability Office, Medicare incurred $54.3 billion in "improper payments" in fiscal year 2024, while Medicaid racked up $31.1 billion. Meanwhile, the Department of Government Efficiency is reportedly probing broader healthcare program spending. Improper payments of this magnitude are not just numbers on a report—they’re a glaring alarm bell for taxpayers and beneficiaries alike.

It’s clear that the Medicare and Medicaid Fraud Prevention Act is aiming to plug one of the many leaks in this sinking ship of healthcare inefficiencies. Whether this effort will stick the landing in Congress is yet to be seen, but if there were ever a bipartisan issue to rally around, this seems like a no-brainer.