The House Committee on Oversight and Accountability is taking a magnifying glass to the Department of Health and Human Services’ (HHS') distribution of COVID-19 relief funds to hospitals and its work to prevent improper Medicaid payments, according to letters sent by the Republican-led committee this week.
"The Committee is continuing our larger oversight of Centers for Medicare and Medicaid Services (CMS) due to unresolved concerns about billions of dollars in wasted taxpayer funds each year,” Committee Chairman James Comer, R-Kentucky, wrote this week.
The first letter (PDF), sent to HHS Secretary Xavier Becerra on Tuesday, criticized the department’s “misallocation” of Provider Relief Fund (PRF) payments to “highly profitable hospitals in wealthy areas while rural hospitals risked going bankrupt as they tried to provide care to Americans in need.”
The letter from Comer and member Nick Langworthy, R-New York, heavily cited a December Wall Street Journal investigation that found roughly a third of hospitals’ PRF support was given to profitable hospitals.
“Inova Health Systems in Northern Virginia, which received $186.1 million, eliminated more than 400 jobs while reporting a profit of $255.5 million in 2020 and 2021,” they wrote. “Meanwhile, in Elmira, NY, the Arnot Ogden Medical Center received just $18.5 million despite losing money in 2020 and 2021 due to lost revenue caused by the pandemic response.”
The lawmakers gave HHS a two-week deadline to provide documents and communications regarding PRF allocation decisions and recoupment as well as a full list of the organizations that received PRF funds. The request includes any related correspondences between HHS and the White House since President Joe Biden stepped into office.
The second letter (PDF), also penned by Comer, was sent to U.S. Government Accountability Office (GAO) Comptroller General Gene Dodaro on Wednesday. It highlighted CMS’ pledge to work closely with state auditors to ensure accountable Medicaid spending but noted that “Republicans are concerned with the lack of improvement to Medicaid’s fiscal responsibility.”
“Despite numerous attempts by congressional Republicans to conduct oversight of CMS and the Medicaid program, the agency has failed to take the necessary steps to monitor state Medicaid programs and recoup improper payments,” Comer wrote. “In order for us to conduct oversight of rampant waste in the Medicaid program, it is vital that GAO initiate a study of CMS’ plans to improve monitoring of state Medicaid eligibility and recoup improper payments.”
Comer’s letter cited HHS’ FY2021 report (PDF) estimating that $98.7 billion (21.7%) of the payments made by Medicaid were improper, largely due to lacking or insufficient documentation. He also suggested that the pandemic freeze on Medicaid disenrollment “further prevented states from removing ineligible enrollees, compounding existing improper payment abuses.”
Comer, on behalf of the committee, requested GAO review state auditors’ Medicaid program findings, explore any factors that facilitate or limit state auditor’s capabilities and suggest approaches for how states and CMS can use state auditor findings to improve Medicaid oversight.
Accompanying releases and prior hearings held by the oversight committee have framed these and other efforts—including probes into upcoming Medicaid redeterminations or COVID-19 origin investigations—as a Republican-led push to increase public health and spending accountability within the government. The committee has so far held 18 hearings and sent more than 100 investigative letters during the first 100 days of the new session, per a Thursday statement.