Senator Chuck Grassley and Seema Verma Discuss the Importance of the False Claims Act to CMS

By David Filbert and Daniel Miller 

On February 16, 2017, the Senate Finance Committee held a confirmation hearing for Seema Verma to become the nation’s next Administrator of the Centers for Medicare and Medicaid Services (“CMS”).  During her testimony, Senators raised wide-ranging questions about the best ways to maintain the quality of the Medicare and Medicaid programs while ensuring the programs’ financial stability.  Ms. Verma stated throughout the hearing that she would try all options and methods to protect and enhance the healthcare programs.

When it came time for Senator Chuck Grassley to ask questions, he wanted to know about Ms. Verma’s commitment to the False Claims Act (“FCA”) and fighting fraud in the programs.  He said, “Coming from an Administration that wants to drain the swamp, I would expect changes to be made under your leadership…”.[1]  Senator Grassley then prefaced his questions by mentioning discussions he has had with CMS in which the agency said it doesn’t have much authority to do anything against frauds in its own programs even if the frauds are in clear violation of the law.  This comment surprised the Senator, who then requested that Ms. Verma take a look into the CMS’ interpretation of its authority to stop fraud.  Grassley said that oftentimes money is taken wrongly from the programs and there is no way to get it back.

Senator Grassley said there are “a lot of tools available to the government to fight fraud…the most effective one is the False Claims Act.”[2]  He then pointed out that since 1987, the Department of Justice has used the FCA to recover almost $34 billion just from health care fraud alone, and that cooperation between the Justice Department and CMS is very important in these cases.  Senator Grassley asked Ms. Verma if she would commit to proactively cooperating with the Department of Justice in fraud cases and to fully support the use of the FCA to combat fraud on government healthcare programs.  Ms. Verma said “…I will absolutely do that.”[3]  She applauded Senator Grassley’s efforts on the FCA, which has been “…an integral component of preventing fraud and recovering dollars when there is fraud.”[4]   So it seems at the outset, even before her administration begins at CMS, that Ms. Verma will look to the FCA as one of her options to support and protect the Medicare and Medicaid programs.

Ms. Seema Verma is the President and founder of SVC, Inc., a national health policy consulting company, and was the architect of the Healthy Indiana Plan (HIP), the nation’s first consumer directed Medicaid program. She has worked for years in Indiana with Governors Mitch Daniels and Mike Pence managing the state’s Medicaid program and has been a consultant with extensive experience redesigning Medicaid programs in other states[5].  She holds a Masters of Public Health Degree from Johns Hopkins University and was nominated to serve as CMS Administrator on November 29, 2016.  CMS is the world’s largest health insurer, covering over one-third of the U.S. population through Medicare and Medicaid alone.  It has a budget of over one trillion dollars and it processes over 1.2 billion claims a year for services provided to some of our nation’s most vulnerable citizens.”[6]

Ms. Verma’s nomination was voted out of the Senate Finance Committee on March 2, 2017.  A vote for confirmation from the full Senate will occur in the coming days.

[1]  Senate Finance Committee Hearing, February 16, 2017.  Senator Grassley portion of video begins at time mark 46:48

[2] Ibid.

[3] Ibid.

[4] Ibid.

[5] Seema Verma background  See Health Affairs Blog:

[6] Senator Orin Hatch press release on Confirmation Hearing of Seema Verma, February 16, 2017.

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By | 2018-03-26T01:05:28+00:00 March 6th, 2017|False Claims Act Legal News|