U.S. Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. criticized the “pay and chase” system for Medicare and Medicaid payouts that funds fraudulent claims and tries to reclaim the money later during a Thursday hearing.
“Under the Biden Administration, we were paying claims that we knew were fraudulent before we paid them. It was called the ‘pay and chase’ system, and we’ve ended that now, so now we look at every claim and make sure that it is not fraudulent,” said Secretary Kennedy.
In Maine, alleged fraudsters have been able to bill MaineCare, the state’s Medicaid program, for millions of dollars. They are then only occasionally asked to repay any of those funds by the state following audits.
In many cases, even while audits are ongoing or while the state is awaiting repayment of overbilled funds, MaineCare continues to hand out millions to the business responsible for overbilling.
In February, the Centers for Medicare & Medicaid Services announced that it would be ending its “pay and chase” system and replacing it with a proactive ‘detect and deploy’ strategy that aims to use AI tools to identify and stop fraudulent payments before they are issued.
Kennedy’s Thursday comments came during a wide-ranging hearing of the Congressional Ways and Means Committee.
“Fraud has become rife throughout our system. We estimate the cost of it to the American taxpayer is about $100 billion a year. If we stop fraud just in Medicare, we can extend that program for another five years,” said Kennedy.
Kennedy also blamed the Biden Administration for “deliberately” weakening program integrity in the Medicare system.
During the hearing, Kennedy also announced that the HHS has shut down 500 fraudulent hospices in Los Angeles, California.
The full hearing is available here:
