Tuesday, December 18, 2007

NBC Reports Rampant Fraud in Medicare

On December 10th & 11th, NBC's Nightly News aired a two-part series that documented massive, widespread fraud successfully conducted by criminals who claim Medicare payments for non-existent services & equipment.

It is easy to make $6 million a year by defrauding the compliant, predictable, "trusting" Medicare system, with little risk of getting caught or punished. Read the articles only if you are prepared to become outraged.

While this system wastes
$60 billion a year in bogus claims paid, the loss is dutifully covered by U.S. taxpayers, who are compelled to support Medicare with taxes automatically deducted from their payrolls.

The articles report little or no response to complaints made by users or providers who identify obvious fraud situations. This fraud appears systemic in a program originally intended to help seniors. Such fraud, like a growing parasite, could threaten its collapse. It already severely compromises its mission.

Criminal fraud is already a "national scourge" crippling the Medicare system. With anticipated increased enrollment by the "baby boomers", such fraud could undermine its processing of payments for basic services, or the political support for its continued funding.

These are the articles in the series, both by Mark Potter, available online:

Here are some snippets from the extensive (5 webpages) series:
Law enforcement officials said it's just one of the many widespread, organized and lucrative schemes to bilk Medicare out of an estimated $60 billion dollars a year — a staggering cost borne by American taxpayers.

Officials say the array of criminals running these schemes are stealing blatantly from the social safety net that cares for 43 million seniors and the disabled, and along the way are hurting honest patients, physicians and legitimate businesses. * * *

Most taxpayers likely have no idea of the scope and cost of the Medicare billing schemes, which they all fund through their payroll deductions.

To show just how bad it can be, federal officials in Miami pointed to a red electric wheelchair they seized from an illicit company. Normally it would cost about $5,000. But by billing Medicare over and over, nor ever delivering the wheelchair to an actual patient, criminals charged a total of $5 million for that one item alone. * * *

"We are up against an organized foe here, this is very organized," said HHS Secretary Leavitt, referring to the many experts who specialize in setting up illicit medical companies.

Kirk Ogrosky, who headed the Justice Department strike force against Medicare fraud in South Florida said, "The problem stems from what we've seen in our cases, time and time again, is that there's a culture of corruption. This culture starts with the patient." * * *

In a recent interview with NBC News, a man who made millions of dollars by defrauding Medicare before his arrest explained how easy it was to steal from the government. * * *

One thing he found shocking was how agreeable Medicare was in paying his phony claims, even after patients whose names were used without permission filed complaints.

"Why is Medicare paying" he asked. "Medicare keeps on paying, so who's at fault? I think the government is at fault, the government doesn't have any control of this."

The man said stealing from Medicare can be a very lucrative endeavor. "If in a year you want $6 million or $8 million you can do it." * * *
Comments by television viewers and by readers on NBC/MSN blogs independently confirm the key points of the investigative reports:
The Centers for Medicare & Medicaid Services issued a short response to the series. See: "Response by The Centers for Medicare and Medicaid Services".

This is one of the most scathing reports on government waste, mismanagement, and unresponsiveness that I have ever read.

taxpayer, any patient under Medicare, any provider in the Medicare system -- each should be devastated. And then all should demand reform & safeguards.