{"database": "press", "table": "releases", "rows": [["https://www.warren.senate.gov/newsroom/press-releases/ahead-of-fiscal-year-fy-2025-ndaa-vote-warren-presses-pentagon-on-strategy-to-prevent-price-gouging-overpayments-to-health-care-companies", "Ahead of Fiscal Year (FY) 2025 NDAA Vote, Warren Presses Pentagon on Strategy to Prevent Price Gouging, Overpayments to Health Care Companies", "2024-12-12", "2024", "2024-12", "Democrat", "Senate", "MA", "Elizabeth Warren", "W000817", "www.warren.senate.gov", "warren", "https://www.warren.senate.gov/newsroom/press-releases", "scraper", "Ahead of Fiscal Year (FY) 2025 NDAA Vote, Warren Presses Pentagon on Strategy to Prevent Price Gouging, Overpayments to Health Care Companies\n\nWarren Reveals List of Nearly 250 Bad Actors that Overcharged DoD by Almost $46 Million\n\n\u201cIt is critically important that DHA properly prevents and mitigates overpayments and price\n\ngouging in TRICARE.\u201d\n\nText of Letter (PDF) | DoD\u2019s January 2024 Response (PDF)\n\nWashington, D.C. \u2013 U.S. Senator Elizabeth Warren (D-Mass.) sent a letter raising continued concerns about the Department of Defense\u2019s (DoD) failure to prevent price gouging and overpayments in the military\u2019s TRICARE health program. DoD\u2019s response to Senator Warren\u2019s July 2023 letter revealed a list of nearly 250 bad actors who have overcharged our military by nearly $46 million, which the Senator released today. In her new letter, Senator Warren requested further information about the department's plans to prevent overcharging.\n\nDoD relies on \u201cseveral managed care support organizations to deliver health care entitlements\u201d to servicemembers and veterans in a cost-effective manner. In December 2022, DoD awarded the most recent generation of these contracts, including a $70.9 billion contract to Humana and a $65.1 billion contract to TriWest Healthcare Alliance. DoD\u2019s response does not make clear if DoD is receiving any discount on care and whether any rebates or incentive payments have been made to the managed care support contractors.\n\nDoD\u2019s response also highlighted potential conflicts of interest among contractors who provide both claims-processing services and serve TRICARE patients. For example, PGBA, a DoD claims processing subcontractor, owns UCI Medical Affiliates, Inc., a health care service provider that services the TRICARE East Region. This dual ownership means that this claims processor could be more likely to \u201cprocess and accept claims, including potentially improper ones, from [its subsidiaries] because it would benefit their shared parent corporation.\u201d\n\nSenator Warren also pressed DoD to provide more information about ethics concerns regarding former Defense Health Agency (DHA) Director Raquel Bono, a key figure in the failure to address previous overpayments. The DoD Inspector General, after determining that the agency had been overcharged, reported that Bono \u201cdisagreed with the recommendations to seek voluntary refunds from TRICARE providers\u201d that had overcharged the program. Bono left government service shortly after and joined the board of Humana, a military health care provider. DoD did not provide an adequate response on this point and redacted critical information in the post-Government employment opinion letters it provided to Bono.\n\nWhile DoD provided a list of nearly 250 companies or providers who have overcharged the Pentagon over the past five years, it only listed the \u201c[a]mount of recommended recoupment\u201d \u2013 a total of nearly $46 million and failed to provide clarity on the final amounts that DHA recovered. In some of the worst cases, these companies had a history of nefarious behavior, needing to pay to resolve allegations of violating the False Claims Act for \u201ccrushing up pills and [including] them in creams used topically for pain treatment,\u201d and submitting false claims to TRICARE to boost profits.\n\n\u201cIt is critical that DoD is taking appropriate steps to prevent repeat overpayment offenders, and I request additional information from you regarding whether DoD continued contracts with any of the providers on this list, including whether it did so even after a company overcharged DoD the first time,\u201d wrote Senator Warren.\n\nSenator Warren also wrote about her concern with DoD\u2019s \u201cfailure to track what [DoD] deem[s] as \u2018accidental errors\u2019,\u201d which can be duplicate payments, patient coding errors, or incorrect calculations of amounts to be paid.\n\n\u201cIt is unclear how you determine that these are \u201caccidental errors\u201d and not deliberate, and I am also concerned by your decision to not track these errors to begin with,\u201d said Senator Warren.\n\nIn order to improve transparency around DoD\u2019s efforts to prevent price gouging, Senator Warren requested DoD provide further clarity on their efforts by December 31, 2024.\n\nSenator Warren has led work to hold giant corporations accountable for price gouging consumers and the government and has urged DoD to crack down on these efforts:\n\nIn June 2024, Senators Elizabeth Warren, Mike Rounds (R-S.D.), Peter Welch (D-Vt.), U.S. Representative Buddy Carter (R-Ga.), and 20 other lawmakers sent a letter to Assistant Secretary of Defense for Health Affairs Dr. Lester Martinez-Lopez and Director of the Defense Health Agency (DHA) Lieutenant General Telita Crosland, raising concerns over Express Scripts\u2019 exclusive contract to administer TRICARE\u2019s pharmacy program, the healthcare system for the military, retirees, and their families.\n\nIn July 2023, U.S. Senator Elizabeth Warren chaired a hearing of the Senate Armed Services Subcommittee on Personnel. She called out the Department of Defense (DoD) for wasting billions in taxpayers dollars due to price gouging by defense contractors for services and in health care, and identified opportunities for cost savings when DoD buys personnel-related goods and services.\n\nIn July 2023, U.S. Senator Elizabeth Warren (D-Mass.) sent a letter to Secretary of Defense Lloyd J. Austin III and Director of the Defense Health Agency (DHA), Lieutenant General Telita Crosland, regarding a series of DoD Inspector General (IG) reports finding that the Department of Defense (DoD) is failing to prevent price gouging and overpayments to contractors in the TRICARE health program.\n\nIn June 2023, Senators Warren and Mike Braun (R-Ind.), alongside Rep. Garamendi, reintroduced the bipartisan Stop Price Gouging the Military Act, which would close loopholes in current acquisition laws, tie financial incentives for contractors to performance, and provide the Department of Defense (DoD) the information necessary to prevent future rip-offs.\n\nIn May 2023, Senator Warren and Representative John Garamendi sent letters to DoD, Boeing, and TransDigm on companies\u2019 refusal to provide cost or pricing data.\n\nIn May 2023, Senators Warren, Sanders, Braun, and Grassley sent a letter to DoD urging an investigation into contractor price gouging.\n\nIn October 2022, Senator Warren obtained a commitment from DoD not to increase contract prices due to inflation.\n\nIn October 2022 Senator Warren sent a letter to DoD urging them to insist on receiving certified cost or pricing data to justify any contract adjustments.\n\nIn June 2022, Senator Warren and Representative Garamendi introduced the bicameral Stop Price Gouging the Military Act, which would enhance DoD\u2019s ability to access certified cost and pricing data. Part of Senator Warren\u2019s legislation was incorporated into the FY 2023 National Defense Authorization Act reported to the Senate.\n\nOn May 12, 2022, Senators Warren and Tammy Baldwin (D-Wisc.) and Rep. Jan Schakowsky (D-Ill.) introduced the Price Gouging Prevention Act of 2022, which would prohibit the practice of price gouging during all abnormal market disruptions \u2013 including the current pandemic \u2013 by authorizing the FTC and state attorneys general to enforce a federal ban against unconscionably excessive price increases, regardless of a seller's position in a supply chain.\n\nOn March 16, 2022, Senator Warren introduced the Prohibiting Anticompetitive Mergers Act to help stomp out rampant industry consolidation that allows companies to raise consumer prices and mistreat workers. The bill would ban the biggest, most anticompetitive mergers and give the Department of Justice and FTC the teeth to reject deals in the first instance without court orders and to break up harmful mergers.\n\nOn March 2, 2022, Senator Warren and her colleagues called out drug manufacturers for squeezing American families with rapid and widespread price hikes on prescription drugs.\n\nIn February 2022, at a hearing, Senator Warren called out corporations for abusing their market power to raise consumer prices and boost profits.\n\nThat same month, Senator Warren requested the Department of Justice to take aggressive action against corporations violating antitrust laws to hike prices for consumers.\n\nIn January 13, 2022, Senator Warren questioned Federal Reserve nominee Lael Brainard about market concentration and price gouging driving inflation.\n\nAt a hearing in January 2022, Senator Warren pressed Fed Chair Jerome Powell on the role of corporate concentration in driving up prices for consumers during his renomination hearing to be Chair of the Board of Governors of the Federal Reserve System.\n\nIn December 2021, Senator Warren slammed Hertz's $2 billion dollar buyback plan, which would line the pockets of company executives and the private equity firm Apollo Global Management, while they raised rental car costs for consumers.\n\nIn November 2021, Senator Warren identified 11 energy companies for inflating natural gas prices for consumers while reaping record profits.\n\nThat same month, she requested the Department of Justice to investigate the poultry industry's anticompetitive behavior as turkey and chicken prices soar.\n\nIn the past year, Senator Warren has urged the Biden administration to closely scrutinize potential anticompetitive mergers that could lead to higher prices for consumers and accelerate industry consolidation. She has led letters about the proposed mergers of Frontier and Spirit airlines, Sanderson-Wayne, WarnerMedia-Discovery, and Amazon-MGM.\n\nIn September 2020, Senator Warren and Representative Ro Khanna (D-Calif.) formally requested that the Department of Defense (DoD) Inspector General (IG) investigate reports that the Pentagon redirected hundreds of millions of dollars of funds meant for COVID-19 response via the Defense Production Act (DPA) to defense contractors for \"jet engine parts, body armor and dress uniforms.\u201d\n\nIn May 2020, Senator Warren wrote to the Department requesting clarification on how the Department would prevent profiteering following a recent change to increase payments to contractors in response to the COVID-19 pandemic.\n\nIn March 2020, Senator Warren joined her colleagues in urging the FTC to use its full authority to prevent abusive price gouging on consumer health products during the COVID-19 pandemic.\n\nIn May 2017, Senator Warren sent a letter to the Department of Defense Inspector General asking for an investigation into defense contractor TransDigm\u2019s refusal to provide cost information to the Department of Defense.\n\n###", 1, "2026-03-30T01:40:41Z", "2026-04-06T19:07:19Z"]], "columns": ["url", "title", "date", "year", "month", "party", "chamber", "state", "member_name", "bioguide_id", "domain", "scraper", "source", "date_source", "text", "has_text", "collected_at", "updated_at"], "primary_keys": ["url"], "primary_key_values": ["https://www.warren.senate.gov/newsroom/press-releases/ahead-of-fiscal-year-fy-2025-ndaa-vote-warren-presses-pentagon-on-strategy-to-prevent-price-gouging-overpayments-to-health-care-companies"], "units": {}, "query_ms": 2.0791918504983187, "source": "dwillis/congress-press", "source_url": "https://github.com/dwillis/congress-press", "license": "MIT", "license_url": "https://github.com/dwillis/congress-press/blob/main/LICENSE"}