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REMARKS BY KEVIN THURM, U.S. DEPUTY SECRETARY OF HEALTH AND HUMAN SERVICES
PLACE: AOA CONFERENCE ON HEALTH CARE FRAUD, WASTE AND ABUSE
DATE: AUGUST 17, 1998

I am honored to join each of you here this afternoon to talk about where we've been and where we must go in our fight against health care fraud.

Before I begin, let me just take a minute to offer my own and Secretary Shalala's congratulations to the senior volunteers who will be recognized at a reception later tonight. Along with 2,500 other senior volunteers around the country, your dedication and commitment have greatly contributed to our efforts to fight fraud and protect the rights older Americans and, indeed, all Americans.

Hollywood may have given us the "ghost busters." But we in the Federal Government are proud to have sponsored the "fraud-busters." Thanks to you, when it comes to health care fraud, we know the answer to the question: "Who you gonna call?"

I understand that your class is already producing big dividends. One fraud-buster from Waterloo, Iowa - a woman 75 years young - recently noticed that Medicare was making a double payment on her influenza-prevention shot. Her awareness and quick action saved Medicare over one million dollars on thousands of flu shots. That's not bad for a day's work.

And over the last five years, this Administration has certainly put in its share of hard work to ensure the promise of health and hope for older Americans. Indeed, President Clinton, Secretary Shalala and the entire Department have fought hard to keep America's promise to senior citizens. Together with many of you here, we've fought to keep the care in Medicare, the trust in the Medicare Trust Fund, and the security in Social Security.

But perhaps one of the best things we've done is to take the fight against health care fraud to new heights.

You know that health care fraud, waste, and abuse affects all of our lives. It robs our taxpayers, undermines confidence in our health care system, taints the reputation of the vast majority of health care providers who are doing a great job, and ultimately erodes the quality of health care for our children, families, seniors, and our most vulnerable Americans.

And that's exactly why this meeting - this partnership -- is so crucial.

As you know, the central aim of our efforts is really quite simple. To root out the scam artists and rotten apples whose golden rule is to prey on people in their golden years and the system that protects them.

To put our efforts in perspective, let me draw an analogy from today's sports headlines. If you're a baseball fan like me, you probably know there's a big race to see who will hit the most home runs this season. Mark McGwire is currently on pace to break the record.

All year long, opposing pitchers have tried to develop an effective strategy against him. I'm told they've come up with a few rules that I thought I'd share with you.

Rule number one: Pitch inside. He's too big and muscular to handle it. Rule number two: Whatever you do, don't pitch inside. He devours inside pitches. Rule number three: Throw fastballs. He's too big and doesn't have good reaction time. Rule number four: Don't throw fastballs. He's got the best concentration and the quickest swing in the league.

I'm sure you can see where I'm going with this. The bottom line is that when pitchers go up against McGwire, they're often facing a lose-lose situation.

And that's exactly what we want every health care scam artist to face when they go up against the tax payers and our senior citizens.

Together, we are stepping up to the plate and making it happen every day. Earlier this year, President Clinton sent to Congress the first report on our fraud-busting progress, and the results have been remarkable. In 1997 alone, nearly $1 billion dollars was returned to the Medicare Trust Fund - that's a billion dollars in one year. That's on top of the $7.5 billion dollars we saved by doing things like preventing inappropriate payments.

To date, we've barred more than 2,700 individuals and health care providers from doing business with Medicare and Medicaid for fraud and other professional misconduct. We've increased convictions for health care fraud-related crimes by nearly 20% and pursued over 4,000 civil health care fraud cases, an increase of 61% over 1996. All told, we've dramatically increased the number of health care fraud convictions by 240 percent, saving the taxpayers more than $20 billion dollars.

And now for the first time -- thanks to the Health Insurance Portability and Accountability Act -- we also have a stable source of funding for controlling fraud. It's called the Health Care Fraud and Abuse Control Account. It allows us to use money from Medicare Trust Fund to finance more fraud and abuse control activities.

As investments go, fraud-busting is better than the stock market. Every dollar spent by our Operation Restore Trust strike force returned $23 dollars in overpayments.

What's more, last year, we fought for - and won - many important weapons to help us combat fraud. These include barring felons from participating in Medicare and Medicaid, as well as new efforts in fighting fraud and abuse in the home health industry - one of the fastest growing segments of our health care system.

These are just some of the accomplishments we can all take pride in. But they are accomplishments to build on -- not rest on.

That's why the President has proposed an anti-fraud and abuse legislative package as part of his FY 1999 budget that would save Medicare some $2 billion dollars over five years. And that's why we are continuing to strengthen and empower everyone in our vast network - our state and area agencies on aging, tribal organizations, ombudsman programs, service providers, senior centers, caregivers, and volunteers in virtually every community through out our country.

Because it will take more than one or two home runs to win the fight against fraud. It will take more hard work, more teamwork, and more determination than ever. And it starts with the determination to maintain and improve the remarkable teamwork in HHS among the Office of the Inspector General, the Health Care Financing Association, and the Administration on Aging.

We must be more determined than ever to invest new resources, smarter thinking and greater attention at every level. We must be more determined than ever to offer the promise of Medicare and Medicaid to millions of children and seniors who need health care. We must be more determined than ever to get the most from every Medicare and Medicaid dollar. And with the aging American population, we must be more determined than ever to protect the promise of Medicare well into the future.

I am here to tell you that at HHS - as my colleagues in the Office of the Inspector General, the Health Care Financing Association, and the Administration on Aging will affirm -- fraud-busting is one of our highest priorities.

Yes, we are anxious to hear from you about how to do the job better. But I also want to encourage you to hold me - along with my colleagues -accountable for results.

So over the next few days, I encourage you to speak out with a strong voice. To give us advice. And to share your experiences on what works - and what doesn't.

Most of all, we need you to keep up the watch.

So let's continue to send a warning to anybody who sees Medicare and Medicaid as easy pickings. Let them know we're coming after them -- stronger than ever. Let them know we're everywhere -- at the federal, state and local level, both public servants and private citizens and service providers -- hospitals, doctors, home health agencies and labs. Let them know that their crime is a lose-lose situation no matter how they look at it.

The American people have counted on the promise of Medicare and Medicaid for more than 30 years. By fighting fraud, we can - and will -- keep this promise.

Thank you.

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