New bipartisan proposal targets ‘one of the most egregious’ kinds of fraud ravaging healthcare industry

EXCLUSIVE: A Medicaid and Medicare fraud crackdown is anticipated with a bipartisan congressional proposal to check Social Security Administration death records.

The legislation, dubbed the Medicare and Medicaid Fraud Prevention Act, would mandate state governments to see if the Social Security Death Master Files show physicians who are still considered part of the government programs meant for seniors and low-income Americans. The check is meant to ensure that the doctor’s National Provider Identifier will not be used by bad actors to commit fraud.  

“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.” Rep. Gabe Evans, R-Colo., who is running the bill with Rep. Scott Peters, D-Calif., said in a statement to Fox News Digital. 

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Legislation under the same name was introduced by former Rep. Mike Garcia, R-Calif., and Peters last year. The bill passed the House and was referred to the Senate Finance Committee, but no further action was taken after that point.  

“Fraud in Medicare and Medicaid hurts the rightful beneficiaries of those programs and all taxpayers,” Peters said in a statement at the time. 

“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,” the congressman added.

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The legislation’s introduction comes as there is heightened scrutiny on the program at both the state and federal levels. In Evans’ home state of Colorado, $7.3 million was given to insurance companies to care for deceased Medicaid recipients, The Denver Post reported.

Meanwhile, California is facing scrutiny for a $9.5 billion price tag for its Medicaid affiliate, Medi-Cal, despite originally only expecting it to cost $6 billion.

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While California Gov. Gavin Newsom did say that illegal immigrants now being able to enroll in the program is part of the issue, he argued that the Golden State is like Colorado, Pennsylvania and Indiana when it comes to higher costs for operating the program across the board.

In fiscal year 2024, there were $54.3 billion in “improper payments” for Medicare and $31.1 billion for Medicaid, according to the Government Accountability Office. Meanwhile, the Department of Government Efficiency has reportedly looked into government healthcare program spending.