Democrats at a joint hearing of two House Ways and Means subcommittees today talked about giving state regulators the authority to oversee the Medicare Advantage program.
The Ways and Means Health Subcommittee and the Oversight Subcommittee convened the hearing to review the statutorily required audits of Medicare Advantage plans.
Rep. Fortney Pete Stark, D-Calif., chairman of the Health Subcommittee, said the real subject of the hearing is CMS neglect of Medicare Advantage programs.
"The focus of this hearing is on private government contractors receiving billions of dollars to administer a government program with no oversight or control by the [Bush] administration," Stark said.
The U.S. Government Accountability Office concluded in a report released today that the CMS has failed to meet minimum Medicare Advantage plan auditing requirements.
"GAO reports that CMS audits only a small percentage of the bids that plans submit – even though the law requires them to audit one-third," Stark said at the hearing. "What's even more disturbing is that while they have failed to meet the terms of the law, even the small percentage they review reveals large discrepancies with millions of dollars in lost benefits and incorrect accounting. The few audits that are actually performed only show us what plans offer, not the benefits that they actually deliver. In a $73 billion program, we have no idea what benefits are being delivered. That's not good government, it's dereliction of duty."
Rep. Rahm Emanuel, D-Ill., said Congress faces a choice between having the CMS "do what it is supposed to" or giving the states more authority to oversee Medicare Advantage plans.
"Somebody has got to do the policing," Emanuel said.
Timothy Hill, the CMS chief financial officer, said the agency will be taking a far more active role in ensuring that the agency meets Medicare Advantage auditing requirements.
Rep. Earl Pomeroy, D-N.D., then suggested that the CMS did not even have the resources to audit the plans.
