The legislation would also require Medicare and its private contractors to verify claims submitted by hospitals, doctors, medical equipment suppliers, healthcare clinics and others before reimbursing them.

In other words, Martinez wants Medicare to start operating more like a credit-card company, with sophisticated anti-fraud computer software programs to immediately detect suspicious use of a customer's card.

And he's willing to invest hundreds of millions of dollars in upgrading Medicare's antiquated system if it means catching more Medicare offenders at the front end.

''It's not just more government spending for the sake of government spending,'' Martinez told The Miami Herald, citing a U.S. Department of Health and Human Services finding that $1 spent on prevention would stop $10 in fraud. ``That's a pretty good return on your investment.''

Sen. Chuck Grassley, R-Iowa, the ranking member of the Senate Finance Committee, said Congress over the years strengthened laws to allow private citizens and government authorities to combat healthcare fraud -- including the 1986 False Claims Act Amendments, the 1996 HIPAA law and the 2003 Medicare Modernization Act.

But he acknowledged that legislation to help fortify Medicare's defense against fraud is overdue. ''I agree with its goals,'' he said.

EYE ON AGENCY

Grassley, co-sponsor of the False Claims Act Amendments, said he still thinks Medicare isn't aggressive enough in scrutinizing fraudulent bills. But he admitted that Congress hasn't kept an eye on the agency either.

''Where Congress comes in is to keep on top of it,'' he said. ``From that standpoint, Congress bears some blame for the lack of oversight.''

Veteran Miami U.S. Rep. Ileana Ros-Lehtinen agreed. ''We haven't had any hearings on that at all,'' she said.

Ros-Lehtinen, a Republican, said there's no question that Medicare needs help to fight fraud. But politically, she said, it's always risky for lawmakers to be giving more money to an agency recognized for incompetence.

''If you increase the money for oversight, then it looks like you're fattening up the bureaucracy, even when it's really for oversight and fighting fraud,'' she said. ``It's a difficult choice.''

Her longtime Miami colleague, Lincoln Diaz-Balart, a Republican congressman, declined to be interviewed for this report.

The challenge of transforming any part of Medicare -- the government's second biggest entitlement program -- is all the greater because the system encompasses so many special interests.

Consider this telling example: Congress' recent delay of a new Medicare payment plan that would have drastically reduced government reimbursements for medical equipment by requiring providers to compete on pricing for motorized wheelchairs, hospital beds and other supplies.

The plan, designed to eliminate Medicare's practice of setting generously high prices, also would have required suppliers to go through accreditation to weed out suspicious businesses that fuel fraud.

But last month, just as the competitive-bidding program was rolling out officially in South Florida and nine other regions, Congress put it on ice -- for 18 months. The plan, which Congress had passed as part of the Medicare Modernization Act five years ago, fell victim to lobbying pressure from the medical equipment industry.

The delay was remarkable because that industry accounts for a tiny share -- 2 percent to 3 percent -- of Medicare's total budget.

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