Q&A: Rooting Out Fraud From A to Z

Q: What drives your commitment to congressional oversight?

A: My crusade as a taxpayer watchdog is rooted in fiscal conservatism and Midwestern common sense. Iowans work hard for their money and deserve assurance that their tax dollars aren’t squandered as they cycle through the alphabet soup of federal agencies, from the Army Corps of Engineers to Veterans Affairs. Good government requires transparency and accountability to uphold the public trust. When wrongdoers fleece government programs, misuse public funds for self-enrichment or leverage public authority for self-advancement, it undermines the covenant between “We the People” and our system of self-government. If left unchecked, misconduct and corruption destabilizes our institutions of government, impacts voluntary tax compliance and undercuts vital public services and those served by them. That’s why I have long prioritized congressional oversight. Through key committee assignments and chairmanships in the U.S. Senate, I have used every tool at my disposal to follow the money appropriated by Congress and ensure the laws are faithfully executed. Over the years, I’ve set my sights on financial mismanagement at the Pentagon, cronyism within federal agencies — such as Housing and Urban Development and U.S. Marshals Service — and investigated a broad range of tax-exempt entities. Non-profits receive significant tax advantages and ought to be holding up their end of the bargain providing sufficient public benefit to receive the tax-exempt benefit. When it comes to demanding fiscal integrity, there is no sacred cow immune from congressional oversight as far as I’m concerned. Consider that the nation’s defense is the federal government’s number one job. That makes it all the more indefensible that the Department of Defense is unable to account for hundreds of billions of tax dollars allocated for our Armed Forces and military readiness. We need to hold responsible those who are accountable for wasting precious tax dollars. Every defense dollar wasted is one that isn’t working to modernize our military, support military personnel, or improve readiness to keep us safe. Let’s follow the money trail. For the first time ever, an army of external auditors will work to help put its fiscal house in order with the first-ever, top-to-bottom, department-wide audit due out in November. Although I steered through the legislation in 2010 that gave the Pentagon an additional seven years to clean up its books and prepare for a full audit as required by federal law, I’m not holding my breath. The financial operations at the Department of Defense are mired in “serious financial management problems” as reported again last year by the Government Accountability Office. However, that challenge won’t stop me from poking the hornet’s nest for as long it takes. Exposing how mismanaged funds sting the taxpayer and undermine the Armed Forces is a powerful weapon to identify and implement more effective and efficient use of defense dollars. Transparency makes the government more accountable.

Q: What prompted you to start drilling into allegations of Medicaid fraud linked to pediatric dental services?

A: I learned long ago that the federal treasury is looked upon as the golden goose for wrongdoers looking to enrich themselves at taxpayer expense. A lot of my oversight work stems from whistleblowers who come forward to report misconduct or fraud. Other times, I conduct oversight by requesting internal audits or launching committee investigations. In 2012, I began a bipartisan inquiry with then-Senator Max Baucus to look into questionable billing practices of several corporate-owned dental chains. A federal audit by the Health and Human Services (HHS) Inspector General found one dentist in California billed Medicaid for more than 1,000 pediatric services a day for nearly 100 days. That eye-opener ought to wipe the smile right off any taxpayer’s face. Additional federal audits exposed even more sketchy billing practices in other states. So we followed the money trail. And we found a pattern of abuse linking many questionable billing practices to corporate-owned chains. One particular dental chain appeared to encourage its employee-dentists to perform unnecessary procedures and treatments to boost profits. In a nutshell, the wrongdoers were exploiting underprivileged kids with unneeded, unwanted and unsafe dental procedures to bilk Medicaid. Based upon our recommendation, HHS excluded one particular chain from Medicaid and Medicare for a minimum of five years. At that time, I also requested information about ongoing investigations by the U.S. Justice Department regarding Medicaid fraud by dental chains. My oversight continued in 2015 when I wrote the HHS Inspector General about a Florida pediatric dentist who allegedly provided unneeded tooth extractions and exposed children to unnecessary physical restraints. That doctor eventually closed his practice, surrendered his license, and was indicted on 11 counts of Medicaid fraud. In January of this year, the Justice Department announced a multi-million dollar settlement from another dental management company and affiliated dental clinics for $23.9 million. The government’s investigation was triggered by lawsuits filed under the whistleblower provisions I enacted to the False Claims Act, which permits private citizens to file suit on behalf of the U.S. government. These courageous truth-tellers came forward to report fraudulent activity by health care providers who were essentially siphoning dollars from the federal health care system at the expense of vulnerable young children and taxpayers. The allegations included billing for unnecessary dental procedures, including baby root canals and tooth extractions, to boost profits by defrauding Medicaid. This $23.9 million settlement serves as yet another reminder that whistleblower protections and the False Claims Act are essential and effective to weed out wrongdoers. Bad actors are bad news for good government. That’s why I will continue vigilance in this area to extract wrongdoers and root out fraudulent payments that divert resources away from genuine medical treatments. That includes my work to strengthen my amendments to the False Claims Act that are credited with recovering more than $56 billion to the federal treasury and putting teeth in the Justice Department’s arsenal to fight fraud.

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