On March 25, 2015, a bipartisan group of U.S. Senators reintroduced the Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (“PRIME Act” or “Act”)[1] following the lead of the U.S. House of Representatives, which tapped the bill for reconsideration in February. The PRIME Act would amend the Social Security Act to stiffen protections against Medicare and Medicaid fraud and abuse and to increase fraud detection measures. At the same time, however, the bill places heightened requirements and restrictions on health care entities, increasing regulatory pressure on those who provide care to Medicare and Medicaid beneficiaries.
The PRIME Act has been introduced twice in the Senate, once in 2011 and again in 2013, but died in committee relatively quickly both times. The Act has been reintroduced in both houses of Congress with no changes to the original language. Of course, the changed composition of the Senate after the last election will alter the calculus for passage of this bill in the current Congress.