Last night NBC news reported that Medicare Fraud now comes in at around $600 billion a year. They did not say how much, if any, of that money is ever recovered. $600 billion a year would go a long way towards paying for universal health care without my taxes needing to be raised.
I sent the following letter to my senators, once again imploring that they get a handle on Medicare and then worry about a health care bill.
As always use all or any part in contacting your own representatives.
Dear Senator
Last night NBC News reported that the US goverment (tax payer dollars) pays out $600 billion in Medicare fraud cases every year.
As I have written in the past, the government has to take control of Medicare, close all the loopholes and stop fraud. Once the fraud stops, then the government will have the money they need for universal health care.
Take charge of Medicare, prosecute violators to the extreme, and save our $600 billion a year. Take charge of the money that is being stolen, rather than ask tax payers to provide more.
Congress needs to take control, show leadership, and agressive copmmitment to righting a serious wrong.
Give law enforcement teeth to go after those who defraud the system so that all $600 billion is recovered.
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3 comments:
Mike, you misheard that. The amount of fraud each year is about $60 billion dollars. Over the ten year period, the fraud will amount to $600 Billion.
What do you think fraud is? You say "the government has to take control of Medicare, close all the loopholes and stop fraud."
What loopholes?
These scams are the work of thieves; this is not just a doctor billing for stuff he didn't do (although that happens and should be stopped).
Don't you think the government has been trying to stop the criminals? The FBI has been working on it – and still is; Eric Holder has assigned more resources and other investigators are working on it too.
There are some remedies that will make these scams so much harder to carry out that the big business of ripoffs will get stopped. But they require changes in the laws which are in the proposed Health care reform (HCR) bill as well as funds for stronger policing of fraud. But the bill has stalled.
If you want to find out all the gory details about the biggest fraud scams go to 60 Minutes program for October 19th, on CBS website. They did a fabulous expose on this and what is trying to be done to stop it. You can’t stop it until you change the system, which is what this HCR bill is trying to do.
Every one talks about how the HCR bill is such a complicated mess but they (and maybe you) seem to think that the reform is just about getting health insurance to everyone.
It is not. There are so many things wrong with the health care systems in this country that even stopping this fraud would leave us with an unsustainable system.
People focus on one part and have have their one simple little answer that will make things alright. But it's not simple as saying "fix it" as loud as you can.
The particular scam that generates about a $60B loss each year is a type of identity theft and it is made possible due to a law passed by congress years ago that mandates that Medicare pay providers' claims within 15-30 days. (Doctors and others made a stink about delayed payments.) But that doesn't give clerks enough time to check if all claims are valid. So the money goes out – to the crooks.
Medicare management has not had sufficient funds to hire enough inspectors to check out every new start up supplier before they have made of with a bunch of money. They need to have the flexibility to have different rules for new suppliers. Either the operation must be inspected before they ever file a claim, or each claim needs to be inspected and verified before it is paid unless they have been trouble-free providers for a significant length of time.
These can’t be done without new law. The proposed bill has funds for more enforcement people and law that allows tightening of registration and more restrictions on payouts.
see part 2
part 2
But what is really needed is immediate electronic records showing what doctors actually order for whom and some way to check that what is ordered really gets to a patient or is even appropriate for them. It would be great to have an online, secure database that could let people look at their own accounts periodically and hot lines to call if they notice suspicious activity just as you can check up on your credit card on line.
That is another big expense that is covered in the bill: getting all doctors, hospitals and other providers to use interoperable digital records. Going to electronic records is expensive and people are resistant to doing things a new way. So the government has to help.
Beefing up enforcement and developing a better computer system to monitor some $600 billion a year in claims is a really big job that will require money.
Without that start up money we will get nowhere. Just putting money into getting people insurance coverage is not enough.
One of the best things in the bill is the $14 billion to build about 1500 new Community Health Centers (CHCs). These are primary care medical practices that will be located in underserved areas, primary rural and inner city. There are 1200 now taking care of about 20 million people. The new ones will be able to care for about 25 million more. (This will cover most of the newly insured in 2014 – so we better start now.)
They give excellent full primary care including dental, mental health, prenatal, pediatric, and prescriptions etc. at a lower cost than is now available. People who have access to a primary care doctor stay out of ER rooms. These clinics have a lot of patients who are on Medicaid and Medicare who sometimes have trouble finding a doctor.
Building, equipping and staffing these centers will provide jobs, jobs jobs.
There are funds in the bill for training primary care doctors and for helping pay off their loans. There are funds for training more nurses.
See, there is much more to the bill than you realized and much more than that I have mentioned. The money isn’t all going to subsidies to get people insurance. Most of it is going to make healthcare better for all of us.
And we need it. While 45,000 Americans die each year from lack of access to care, 195,000 Americans die each years from PREVENTABLE medical error. We have got to change that.
Thank you for correcting me on the figures. As far as the government attempting to stop Medicare, Disability and other kinds of fraud and scams you need to look at history. All of these programs were set up for quick turn around, not fiscal responsibilty.
Only recently has funding been approved for investigators. The Social Security Administration has has less than five full time investigators in any state investigationg disability fraud, and that figures into the billions, and is the chief reason the Social Security trust fund is being depleted, its not about retirement benefits.
The same is true with Medicare. Only recently has money started being spent on investigations.
How long has that FBI task force been working in southern Florida? How long has Medicare been paying out funds?
As for Senator Cardin, he is a fraud and an abuser of the truth. During one of his town hall meetings he made a big deal out of the fact that he was receiving Medicare. What he did not explain was that Medicare is his secondary insurer, he is not paying Part B premiums and that thanks to his excellent plan from the US Senate, he will never have to worry about prescription coverage.
I hope you are right about the HCR bill, but when I see the deals that were made for the likes of Senator Ben Nelson of Nebaska's vote, you have to question the sincerity of those who are expecting us to pay for all of this.
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