Sen. Braun demands full audit of Medicare after massive fraud discovery

FIRST ON FOX: Sen. Mike Braun, R-Ind., the ranking member on the Senate Special Committee on Aging, will send a letter to the Government Accountability Office Wednesday requesting a full audit of Medicare following recent reports of fraud. 

In a letter led by Braun, alongside Rick Scott, R-Fla., and JD Vance, R-Ohio, the senators will request GAO Comptroller General Gene Dodaro "audit the Centers for Medicare and Medicaid Services’ (CMS) internal oversight reforms."

The Republicans write that Medicare has an increasing tendancy to be targeted by "highly sophisticated fraud schemes, including online phishing, data breaches, and international fraud rings."

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Sen. Mike Braun, R-Ind. (Al Drago/Bloomberg via Getty Images)

The senators cite an alleged catheter fraud scheme reported last month, in which hundreds of thousands of individuals were billed for catheters despite never ordering nor receiving them. 

According to a report, a health care group, the National Association of Accountable Care Organizations, assisted in recognizing the alleged fraud after reviewing billing data. The organization issued a warning to its members last month, relaying that $2.8 billion in 2023 Medicare claims were connected to the catheters, a 30% jump from prior estimates. 

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The scam has also prompted the Department of Health and Human Services Office of Inspector General to issue a warning to consumers. Per the alert, Medicare recipients are being contacted via "phone calls, internet ads, and text messages" with offers for free services and medical products. However, when the scammer obtains the personal Medicare information of individuals, "monthly billing to Medicare will begin for medically unnecessary urinary catheters that may or may not actually be sent to the enrollee."

Sen. JD Vance, R-Ohio, is a member of the Senate Banking, Housing, and Urban Affairs Committee (Tom Williams/CQ-Roll Call, Inc via Getty Images)

"The victims of Medicare fraud are often the most vulnerable Americans. I’m calling for a full audit of Medicare, so we can get to the bottom of the rampant fraud, waste and abuse," Braun said in a statement to Fox News Digital. "It’s beyond alarming that this recent case of alleged Medicare fraud involving overbilling for urinary catheters went undetected for over a year and accounted for an additional $2.7 billion in taxpayer spending. American seniors deserve better."

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"In the private sector, even a minor level of fraud would lead to an immediate audit of one’s finances," the senators' letter states.

Braun, Scott and Vance point to the GAO's 2022 report, which revealed Medicare reported $47 billion in improper payments. In the past, it was estimated Medicare fraud has cost as much as $60 billion, which the senators also note. 

Sen. Sen. Rick Scott, R-Fla. (Chip Somodevilla/Getty Images)

The group of Republicans explained that the substantial amount of fraud and improper payments "contributes to the nation's $34 trillion deficit." 

According to the senators, a reform that could benefit Medicare is "machine learning," which could assist the program in preventing fraud and minimizing losses. 

In January, Braun joined Sen. Bill Cassidy, R-La., to introduce a bill aimed at stopping Medicare fraud and improving the program's ability to defend against and detect fraud attempts. 

The measure would charge CMS with beginning a two-year pilot that would monitor Medicare-covered durable medical equipment and related purchases. Under the bill's program, Medicare beneficiaries will be asked to verify some of their purchases, thereby affording the CMS more data access while also testing the pilot's effectiveness.