Medicare Accused of Withholding Documents by Top Government Watchdog

A top government watchdog is accusing Medicare of illegally withholding documents from the public, a new lawsuit shows. The Centers for Medicare and Medicaid Services (CMS) is alleged to have withheld documents in a lawsuit filed on July 16 by the Government Accountability Office (GAO). Under the Freedom of Information Act (FOIA), government agencies are
Medicare Accused of Withholding Documents by Top Government Watchdog

A top government watchdog is accusing Medicare of illegally withholding documents from the public, a new lawsuit shows.

The Centers for Medicare and Medicaid Services (CMS) is alleged to have withheld documents in a lawsuit filed on July 16 by the Government Accountability Office (GAO).

Under the Freedom of Information Act (FOIA), government agencies are required by law to provide access to federal records to the public. The lawsuit states that CMS and the U.S. Department of Health and Human Services (HHS) improperly denied an FOIA request by “failing to provide an initial determination” and “produce responsive records.” The initial request was June 12.

President Joe Biden and Vice President Kamala Harris greet audience members during an event promoting lower health care costs in the East Room of the White House on August 29, 2023, in Washington, D.C. Medicare… Win McNamee/Getty Images

“This lawsuit is more than anything else about transparency,” Alex Beene, a financial literacy instructor at the University of Tennessee at Martin, told Newsweek. “GAO is making the argument that Medicare, like most federally funded programs, falls under the duties outlined in the Freedom of Information Act.

“When a government agency fails to provide information, rightfully or wrongfully, it appears to everyone outside of it that organization has something to hide.”

The original FOIA request from the GAO asked for copies of “certain described emails” of three named officials containing particular keywords over a specific period of time.

CMS and HHS did not give the GAO any estimate on the volume of records for a FOIA request they submitted and also didn’t give a date for when the records would be available.

Under FOIA rules, government agencies must respond within 20 working days and include a determination of whether the agency intends to comply with the request and provide reasons for this determination.

CMS and HHS did neither of those by the 20-day deadline of July 12, prompting the lawsuit.

“It’s not just paperwork,” Michael Ryan, a finance expert and founder of michaelryanmoney.com, told Newsweek. “We’re talking about keeping these vital programs honest and open….When something smells fishy with Medicare, we all need to pay attention.”

Ryan said if no one is watching Medicare, the agency could get sloppy and have widespread fraud and waste under the surface.

Previously, a group of senators asked for an audit through GAO after reports of a $2.7 billion Medicare catheter fraud ring, leading to roughly $60 million lost a year in Medicare funding.

“The victims of Medicare fraud are often the most vulnerable Americans,” Senator Mike Braun, an Indiana Republican, said in a statement in March.

“I’m calling for a full audit of Medicare so we can get to the bottom of the rampant fraud, waste, and abuse. 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.”

The current lawsuit might end with the court ordering the information to be released, but CMS could also decide to hand over the documents “to avoid a bigger mess,” Ryan said.

“Either way, I bet other government agencies will be watching very closely,” Ryan said. “We might even see some new rules to keep everyone on their toes.”

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