WASHINGTON--Legislators on the House Budget Committee put Health and Human Services Secretary Mike Leavitt on the hot seat Tuesday as he requested additional funds to fight Medicare fraud.

The Bush administration is asking for $1.3 billion for the Health Care Fraud and Abuse Control program in 2008--$200 million more than the program received in 2007. Of the increase, Leavitt said most would be discretionary spending used to go after fraud in Medicare and improve oversight of Medicaid.

Leavitt said much of the money was needed to pay for and prosecute DME fraud cases in areas like South Florida, where CMS recently announced a major anti-fraud demonstration project. (See HomeCare Monday, July 9.) Leavitt recounted his experience in visiting the area, where he told the congressional panel Medicare is losing millions in payments to sham companies. He said his department is also seeking to change statutes that send recovered funds back into the Medicare trust fund so that they go toward fraud prevention initiatives instead.

But legislators questioned the agency's fraud control efforts to date and asked whether additional funding would be effective.

Rep. Jim Cooper, D-Tenn., said Medicare has let its claims processing contractors "off the hook" and that they should be held accountable. "Don't these payment processors have some responsibility to flag suspicious claims?" Cooper asked. "Are they doing their job?"

Cooper also challenged Leavitt's focus on small providers instead of on large health care companies, which Cooper said seem to regard penalties for Medicare fraud as merely a cost of doing business.

According to the American Association for Homecare, which reported on the hearing in its newsletter, Leavitt also got hard questions from other congressmen, including Rep. Adrian Smith, R-Neb., who asked, "How often are people on the front lines included in the process of preventing fraud?" Rep. Bobby Scott, D-Va., asked about professional education for providers that could reduce mistakes. Rep. Dan Lungren, R-Calif., said he had hoped to hear more in Leavitt's testimony about deterring fraud. "That's what I found missing," he said.

Rep. Patrick Tiberi, R-Ohio, mentioned the "hoops" providers have to jump through to get reimbursed. He commended his state's "strong and active DME industry," and suggested CMS work with DME associations to go after fraud, AAHomecare said.

Committee ranking member Paul D. Ryan, R-Wis., said Congress should look at reforms to ensure federal funds appropriated in the regular budget process are spent wisely rather than appropriating funds year after year for program integrity.