Medicare accused of withholding documents by government’s top watchdog

A top government watchdog is accusing Medicare of unlawfully hiding documents from the public, a new lawsuit says.

The Centers for Medicare and Medicaid Services (CMS) allegedly withheld the documents in a lawsuit filed 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 claims that CMS and the U.S. Department of Health and Human Services (HHS) improperly denied the FOIA request by “failing to provide a preliminary finding” and “failing to produce relevant records.” The initial request was filed on June 12.

“This lawsuit is all about transparency,” said Alex Beene, a financial education professor at the University of Tennessee at Martin. Newsweek“GAO argues that Medicare, like most federally funded programs, is subject to obligations under the Freedom of Information Act.

“When a government agency withholds information, rightly or wrongly, it gives outsiders the impression that the organization has something to hide.”

The original FOIA request filed by GAO sought copies of “certain described emails” of three named officials, containing specified keywords, and covering a specified time period.

CMS and HHS did not provide GAO with any estimates of the number of documents covered by the FOIA request, nor did they provide a date when the documents would be available.

Under FOIA, government agencies must respond within 20 business days, stating whether they intend to comply with the request and the reasons for their decision.

CMS and HHS failed to take either step by the 20-day deadline of July 12, leading to the lawsuit being filed.

“It’s not just paperwork,” said Michael Ryan, financial expert and founder of michaelryanmoney.com Newsweek“We’re talking about keeping these important programs honest and open… When something stinks with Medicare, we all need to take notice.”

Ryan said that if no one monitors Medicare, the agency can become lax and the hidden reality can lead to widespread fraud and waste.

Earlier, a group of senators requested a GAO audit after reports of $2.7 billion in fraud involving Medicare catheters, leading to a loss of about $60 million a year in Medicare funding.

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

“I am calling for a full audit of Medicare so we can get to the bottom of the rampant fraud, waste and abuse. It is beyond alarming that this latest case of alleged Medicare fraud involving overbilling for urinary catheters went undetected for more than a year and accounted for an additional $2.7 billion in taxpayer spending. America’s seniors deserve better.”

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

“Either way, I’m betting that other government agencies will be watching this very closely,” Ryan said. “We may even see new rules that will put everyone on alert.”