August 13, 2010
You Scam, They Scam
I've been holding on to this link because a couple of questions continue to nag at me:
Authorities said busts carried out this week in Miami, New York City, Detroit, Houston and Baton Rouge, La., were the largest Medicare fraud takedown in history -- part of a massive overhaul in the way federal officials are preventing and prosecuting the crimes.In all, 94 people -- including several doctors and nurses -- were charged Friday in scams totaling $251 million. Federal authorities, while touting the operation, cautioned the cases represent only a fraction of the estimated $60 billion to $90 billion in Medicare fraud absorbed by taxpayers each year.
First, did it really require "a massive overhaul" in order to define, discover, and prosecute outright fraud? And if new regulation of some sort was needed, couldn't that have been passed quickly and easily through Congress when the problem was first discovered? Which leads to:
Second, couldn't the savings and recovered money (if any) go toward making Medicare self-sustaining, rather than helping to balance out a costly new entitlement program?
"For the first time federal officials have the power to overhaul the system under Obama's Affordable Care Act, which gives them authority to stop paying a provider they suspect is fraudulent. Critics have long complained the process did nothing more than rubber-stamp payments to fraudulent providers".
"That world is coming to an end," Health and Human Services Secretary Kathleen Sebelius told The Associated Press after speaking at a health care fraud prevention summit in Miami. "We've got new ways to go after folks that we've never had before."
I think medicare fraud investigators should work on commission. Give them 1% of all convictions they bring in. Now we have a motivated workforce.
Posted by: Patrick at August 13, 2010 4:17 PMSince its inception, I have heard through friends and relatives of at least 4 minor medicare scams. If I know this through casual conversation, I wonder what a person who made it their business would know.
I know several people who have made rather large sums of money by reviewing hospital billings (on a commission) to "improve" their Medicare billings.I am not a medical person, but I understand this means re-defining a frature as a break. I wonder how such large sums are possible.
Posted by: Warrington Faust at August 13, 2010 7:20 PMWait a minute... did Justin just come out in favor of something the President did in reforming healthcare? Nearly fell of my chair there.
Posted by: Russ at August 14, 2010 10:25 AM