by Mitch Kokai
Senior Political Analyst, John Locke Foundation
Tucked into an office park is a man who could save taxpayers billions—if the government wanted him to.
Chris Mucke is a recovery audit contractor—a bounty hunter, some would call him—tasked with clawing back improper spending in the prescription drug program for older Americans.
However, Washington really doesn’t want him to do that, he says, highlighting political pressure—from insurers, pharmacies, doctors, hospitals, and patients—to keep the spigots open, no matter how fraudulent or improper the spending.
So now he is suing, and shining a harsh light on what many agree is wild overspending in Medicare, the biggest health-care purchaser on Earth. The $597 billion it spent in 2014 made up 14 percent of the U.S. government’s budget that year.
In two filings with federal claims court seeking $140 million combined, Mucke’s company, ACLR, contends it could have staunched the bleeding of taxpayer dollars but was instead blocked at every turn by federal bureaucrats uninterested in doing so.
In ACLR’s area of focus, Medicare Part D’s popular drug prescription program, the government estimates $1.9 billion was misspent in 2014 alone. From 2011 to 2014, ACLR’s grand total recovered for the government was a paltry $10 million, with the company’s take of the proceeds 7.5 percent to 12 percent.
The Centers for Medicare and Medicaid Services (CMS) repeatedly handcuffed ACLR, the claims contend. Bureaucrats made their position plain at the outset, telling the company at a February 2011 “kickoff party” that they wanted to “minimize the impact on plan sponsors,” primarily the major pharmacy chains whose powerful benefit managers are key intermediaries in the prescription program. The bureaucrats did not want to recover “too much money,” according to the claims.