Lawmaker suggests task force to prevent drug benefit program abuses

A key whistleblower protector on Thursday called for an interagency task force to detect potential fraud in the Medicare prescription drug program.

The benefit program, established in the 2003 Medicare Prescription Drug, Improvement and Modernization Act, is a ripe target for fraud, said Sen. Charles Grassley, R-Iowa. To thwart would-be con-artists, officials at the Centers for Medicare and Medicaid Services, part of the Health and Human Services Department, should collaborate with investigators, prosecutors and law enforcement agencies, he said.

Some drug card scams already have surfaced in the four months since President Bush signed legislation establishing the benefit, said Mark McClellan, head of Centers for Medicare and Medicaid Services. Under the law, 28 sponsor companies will begin distributing prescription drug discount cards to seniors on June 1. The card sponsors cannot solicit door-to-door or cold-call Medicare beneficiaries.

But in about 20 cases, fake card sponsors have canvassed senior citizens for personal information, McClellan said. These cases are under investigation and likely represent isolated incidents, he said. In the meantime, officials at the Centers for Medicare and Medicaid Services are preparing ways to fight additional fraud. For instance, the agency has set up a system to log and respond to beneficiaries' complaints and search for patterns worth investigating, McClellan said.

The Centers for Medicare and Medicaid Services' should establish an interagency task force devoted to "directly and proactively" targeting fraud that will likely "seep into" the program, Grassley said. The agency must also respect, and take seriously, those who come forward and report possible wrongdoing, he added.

The Iowa senator has no plans to introduce legislation mandating a task force. The executive branch has "enough experience in that area" to act on the idea, which is basically a "roughly outlined suggestion," he said.

Grassley advocated the task force at a Capitol Hill event honoring eight whistleblowers credited with unveiling health care fraud and fraud related to Defense Department contracts. The honorees helped the government retrieve more than $3.3 billion.

In addition, Grassley urged fellow lawmakers to support legislative language aimed at bolstering the Internal Revenue Service's handling of tax violation disclosures. The language is included in an international tax reform bill (S. 1637) under consideration in the Senate, and would create a whistleblower protection office within the IRS.

The reform bill also would allow the tax agency to reward citizens exposing waste, fraud and abuse. The provision encourages IRS officials to work closely with whistleblowers and their lawyers, Grassley noted.

Grassley, known as a tireless whistleblower advocate, received an award himself at the Thursday event, from Taxpayers Against Fraud, a Washington-based watchdog group. In 1986, Grassley introduced amendments to the False Claims Act granting those unearthing fraud the right to sue alleged perpetrators on the government's behalf.

If the government chooses to help with such cases, a whistleblower is eligible to receive 15 percent to 25 percent of any resulting settlement. Otherwise a whistleblower can receive up to 30 percent of any settlement. The amended law has helped the government recover more than $12 billion, according to Grassley.

In accepting his award, Grassley praised whistleblowers for showing "extraordinary courage in the face of extraordinary adversity." Those who disclose waste, fraud and abuse, and their families, pay a price for "sticking their necks out," he added.

"It's extremely difficult to be a whistleblower," Grassley said. "They are about as welcome as a skunk at a Sunday afternoon picnic."