Lawmakers probe anti-fraud administrator about problems with $161 million database

A Senate subcommittee on Tuesday lobbed several pointed questions at the CMS' top anti-fraud administrator, asking why a 5-year-old $161 million centralized database has yet to start delivering on its promise of preventing widespread abuse of the Medicare and Medicaid systems.

Dr. Peter Budetti, deputy administrator and director for program integrity at the CMS, acknowledged to the Senate Subcommittee on Federal Financial Management, Government Information, Federal Services and International Security that the central repository of Medicare-Medicaid data was not yet as effective as it could be.

The Medicaid data won't be included in the system until 2014, and less than 100 of the 639 people who needed training to use the systems had received it.

“The agency did set rather ambitious goals for itself in implementing those programs,” said Budetti, who was appointed deputy administrator about two years ago. “Some of those goals have been met, some have not.”

When the programs were first proposed, CMS officials said the Integrated Data Repository and the One Program Integrity program would save $21 billion between 2006 and 2014. More than halfway through that time frame, officials said progress is still unclear, partly because of a lack of benchmarks to measure improvement.

“It is unknown whether the program has produced any financial benefits yet,” said Joel Willemssen, managing director of information technology issues at the U.S. Government Accountability Office, which publicly released a report hours before the hearing criticizing the CMS' handling of the programs.

Lewis Morris, general counsel to the HHS inspector general's office, said the CMS' programs have been estimated to have stopped about 50 payments totaling about $8 million.