Published: 2010-01-04 12:56:13
Author: Suzy Khimm | The New Republic | December 30, 2009
Often preying on the program’s elderly and poor beneficiaries, Medicare fraudsters cost the government $47 billion last year alone, using billing scams that some officials have calledmore profitable than drug-trafficking. Earlier this month, 26 individuals in three cities were arrested a series of raids for bilking Medicare of $61 million, including a Florida doctor accused of running a $40 million scheme that falsely listed patients as blind diabetics so he could bill them for home nursing care. Similarly outrageous scams includefalse claims for power wheelchairs claimed to be destroyed during Hurricane Katrina and drug prescriptions from doctors who have died.
The reform bills moving through Congress commit more than $100 million to prevent fraud and strengthen enforcement practices. And by the time the Senate was finished working on its bill, it had adopted even tougher anti-fraud measuresthan the House had--increasing penalties for health-care fraud, expanding the definition of actionable offenses, and devoting greater resources to fraud detection. Such provisions would beef up the anti-fraud funds that Obama has already pledged to HHS in the 2010 budget, which the agency says could save the government at least $2.7 billion.
But is that enough? According to one recent George Washington University report, the bill’s mandated conversion to electronic claims transactions will both “increase the volume of claims and allow large enterprises to use technology to engage in fraud while avoiding computer fraud detection systems.”Full story