Medicare paid $47 billion in suspect claims
Dom
Govt: Medicare paid $47 billion in suspect claims
By HOPE YEN, Associated Press Writer Hope Yen, Associated Press
Writer
Sat Nov 14, 12:11 pm ET
WASHINGTON – The government paid more than $47 billion in questionable
Medicare claims including medical treatment showing little relation to
a patient's condition, wasting taxpayer dollars at a rate nearly three
times the previous year.
Excerpts of a new federal report, obtained by The Associated Press,
show a dramatic increase in improper payments in the $440 billion
Medicare program that has been cited by government auditors as a high
risk for fraud and waste for 20 years.
It's not clear whether Medicare fraud is actually worsening. Much of
the increase in the last year is attributed to a change in the Health
and Human Services Department's methodology that imposes stricter
documentation requirements and includes more improper payments — part
of a data-collection effort being ordered government-wide by President
Barack Obama next week to promote "honest budgeting" and accurate
statistics.
Still, the fiscal 2009 financial report — covering the first few
months of the Obama administration — highlights the challenges ahead
for a government that is seeking in part to pay for its proposed
health care overhaul by cracking down on Medicare fraud. While noting
that several new anti-fraud efforts were beginning, the government
report makes clear that "aggressive actions" to date aimed at reducing
improper payments had yielded little improvement.
In recent years, the suspect claims have included Medicare
prescriptions from doctors who were dead, and requests for payment for
medical supplies such as blood glucose strips for sexual impotence and
diabetic shoes for leg amputees. Patients, many of them new citizens
who barely speak English, are sometimes recruited by brokers who go
door-to-door offering hundreds of dollars for use of their Medicare
numbers.
Obama is expected to announce new initiatives next week to help crack
down on Medicare fraud, including a government-wide Web site aimed at
providing a fuller account of health care spending and improper
payments made by various agencies. The Centers for Medicare and
Medicaid Services also will launch a Web interactive next month that
will allow users to track Medicare payment information by categories
such as state, diagnosis and hospital.
According to the report, the Bush administration from 2005-2008
reported improper payments of roughly 4 percent in the fee for service
program, or about $17 billion total in 2008. Government officials at
the time, however, typically did not consider a Medicare payment
improper if the medical documentation was incomplete or a doctor's
signature was illegible. Since these were flaws that ordinarily bar
payment, that methodology drew complaints from government auditors
that the figures were understated.
For fiscal year 2009, the Obama administration began counting those
claims as improper, but was unable to complete an official tally based
on the new methodology. As a result, it officially reported improper
payments for its fee for service program at 7.8 percent, representing
a partial tally under the new formula. But it considers the unofficial
tally of 12.4 percent to be more representative.
Beginning next year, the 12.4 percent figure — or a total of $47
billion in improper payments when counting both Medicare fee for
service and managed care — will be used as the baseline estimate. The
federal report sets a target of reducing improper payments in the fee
for service program to 9.5 percent by next year, which would represent
a savings of roughly $9.7 billion.
The findings come as the Obama administration is making Medicare anti-
fraud efforts an important priority. In recent months, HHS has said it
was multiplying by 10 the number of agents and prosecutors targeting
fraud in Miami, Los Angeles and other strategic cities where tens of
billions of dollars are believed to be lost each year. The new
partnership seeks to have better sharing of real-time intelligence
data on health care fraud patterns.
Officials say they also want to increase training and outreach among
Medicare providers to reduce documentation errors, while proposed
health overhaul legislation would increase background checks on
Medicare claimants and impose stiffer penalties for false claims.
Other findings:
_In the Medicaid program for the poor, roughly $18.1 billion, or 9.6
percent of claims, are believed to be improper payments.
_Using a baseline of 12.4 percent in improper payments in the Medicare
fee for service program, HHS is setting targets of reducing fraud and
waste to 9.5 percent, 8.5 percent, and 8.0 percent, respectively, for
fiscal years 2010 through 2012.
Records released earlier this week showed that CMS for three years
ignored internal watchdog warnings about swindlers stealing millions
of dollars by scamming several Medicare programs. The agency received
roughly 30 warnings from inspectors but didn't respond to half of
them, even after repeated letters.
___
On the Net:
Government anti-fraud page: http://www.stopmedicarefraud.gov/
Werner
> http://news.yahoo.com/s/ap/20091114/ap_on_bi_ge/us_medicare_fraud
>
> Govt: Medicare paid $47 billion in suspect claims
Dollars in the common treasury are like fish in the common sea -
anyone who can will harvest to extinction. That is why socialism is
fundamentally corrupting and can not work. ----
http://www.capitaldistrict-lp.org/how.shtml
http://www.youtube.com/watch?v=Dp8ZmQMCtqA&feature=related
http://www.youtube.com/watch?v=-FSoXKapKQs&feature=related
Michael Coburn
> http://news.yahoo.com/s/ap/20091114/ap_on_bi_ge/us_medicare_fraud
>
> Govt: Medicare paid $47 billion in suspect claims By HOPE YEN,
> Associated Press Writer Hope Yen, Associated Press Writer
> Sat Nov 14, 12:11 pm ET
>
> WASHINGTON – The government paid more than $47 billion in questionable
> Medicare claims including medical treatment showing little relation to a
> patient's condition, wasting taxpayer dollars at a rate nearly three
> times the previous year.
Because in previous years the Republican administration never cared to do
anything other than whine about how social insurance systems cost the
taxpayers bug bucks. The idea of documenting, publicizing, and policing
was never given a thought.
> Excerpts of a new federal report, obtained by The Associated Press, show
> a dramatic increase in improper payments in the $440 billion Medicare
> program that has been cited by government auditors as a high risk for
> fraud and waste for 20 years.
Yup. If we are going the fix this crap we first have to identify what
needs to be fixed in a specific manner that will allow prosecution.
> It's not clear whether Medicare fraud is actually worsening.
This is the only line in the article that is worth spit. It admits that
the situation may not be getting worse but may seem so because the abuse
if actually being chronicled.
> Much of the
> increase in the last year is attributed to a change in the Health and
> Human Services Department's methodology that imposes stricter
> documentation requirements and includes more improper payments — part of
> a data-collection effort being ordered government-wide by President
> Barack Obama next week to promote "honest budgeting" and accurate
> statistics.
Gee..... What-a-concept.
> Still, the fiscal 2009 financial report — covering the first few months
> of the Obama administration — highlights the challenges ahead for a
> government that is seeking in part to pay for its proposed health care
> overhaul by cracking down on Medicare fraud.
Oh, horse crap. The current administration is attempting to actually
root out waste and fraud and prosecute it as opposed to ab-using it to
highlight the failures of social insurance systems.
> While noting that several
> new anti-fraud efforts were beginning, the government report makes clear
> that "aggressive actions" to date aimed at reducing improper payments
> had yielded little improvement.
Yup. True story. The incompetence of the previous administration has
been exposed. We have yet to see what can and will be done by this
administration.
> In recent years, the suspect claims have included Medicare prescriptions
> from doctors who were dead, and requests for payment for medical
> supplies such as blood glucose strips for sexual impotence and diabetic
> shoes for leg amputees. Patients, many of them new citizens who barely
> speak English, are sometimes recruited by brokers who go door-to-door
> offering hundreds of dollars for use of their Medicare numbers.
Yup..... Sounds like a Republican exercise in discrediting government.
> Obama is expected to announce new initiatives next week to help crack
> down on Medicare fraud, including a government-wide Web site aimed at
> providing a fuller account of health care spending and improper payments
> made by various agencies. The Centers for Medicare and Medicaid Services
> also will launch a Web interactive next month that will allow users to
> track Medicare payment information by categories such as state,
> diagnosis and hospital.
Open government and transparency is the way to discover fraud.
> According to the report, the Bush administration from 2005-2008 reported
> improper payments of roughly 4 percent in the fee for service program,
> or about $17 billion total in 2008. Government officials at the time,
> however, typically did not consider a Medicare payment improper if the
> medical documentation was incomplete or a doctor's signature was
> illegible. Since these were flaws that ordinarily bar payment, that
> methodology drew complaints from government auditors that the figures
> were understated.
>
> For fiscal year 2009, the Obama administration began counting those
> claims as improper, but was unable to complete an official tally based
> on the new methodology. As a result, it officially reported improper
> payments for its fee for service program at 7.8 percent, representing a
> partial tally under the new formula. But it considers the unofficial
> tally of 12.4 percent to be more representative.
>
> Beginning next year, the 12.4 percent figure — or a total of $47 billion
> in improper payments when counting both Medicare fee for service and
> managed care — will be used as the baseline estimate. The federal report
> sets a target of reducing improper payments in the fee for service
> program to 9.5 percent by next year, which would represent a savings of
> roughly $9.7 billion.
At least we have an identified target in controlling waste and abuse.
People may quibble over the selection of the baseline and the speed of
getting the job done, but this a lot better than no numbers at all. But
what will happen of course is that the Republican screech monkey will
find a way to claim that Obama lied about it and that the fraud has been
increased.
> The findings come as the Obama administration is making Medicare anti-
> fraud efforts an important priority. In recent months, HHS has said it
> was multiplying by 10 the number of agents and prosecutors targeting
> fraud in Miami, Los Angeles and other strategic cities where tens of
> billions of dollars are believed to be lost each year. The new
> partnership seeks to have better sharing of real-time intelligence data
> on health care fraud patterns.
OH TRAUMA TRAUMA TRAUMA TRAUMA !!!!!!!!!!!!!!! Obama is GROWING the
number of government people. LORD SAVE US!!!!
> Officials say they also want to increase training and outreach among
> Medicare providers to reduce documentation errors, while proposed health
> overhaul legislation would increase background checks on Medicare
> claimants and impose stiffer penalties for false claims.
What!! Actual education and enforcement of the law??? What-a-concept!!!!
> Other findings:
>
> _In the Medicaid program for the poor, roughly $18.1 billion, or 9.6
> percent of claims, are believed to be improper payments.
>
> _Using a baseline of 12.4 percent in improper payments in the Medicare
> fee for service program, HHS is setting targets of reducing fraud and
> waste to 9.5 percent, 8.5 percent, and 8.0 percent, respectively, for
> fiscal years 2010 through 2012.
>
> Records released earlier this week showed that CMS for three years
> ignored internal watchdog warnings about swindlers stealing millions of
> dollars by scamming several Medicare programs. The agency received
> roughly 30 warnings from inspectors but didn't respond to half of them,
> even after repeated letters.
> ___
>
> On the Net:
>
> Government anti-fraud page: http://www.stopmedicarefraud.gov/
--
"Those are my opinions and you can't have em" -- Bart Simpson
Econotron
news:d09d2297-2ab4-4272...@o31g2000vbi.googlegroups.com...
http://news.yahoo.com/s/ap/20091114/ap_on_bi_ge/us_medicare_fraud
Other findings:
On the Net:
===================================================================
This is just Medicare, which is relatively fraud-less. The major fiscal
problem with Medicare is not fraud, but the end-of-life care, where
hospitals treat failing organs, as if dealing with separate diseases. This
runs up the outlays enormously. Medicare pays for all that no questions
asked. But if they don't, they will be sued, and if doctors do not provide
the treatment, they will be also sued, for malpractice. And this particular
side has not been addressed by the so-called "reform" at all. Where fraud
really rampant, is in Medicaid. It is probably in hundreds of billions. One
can imagine what will happen, if the government runs the whole industry.
e.
Sid9
"Werner" <whet...@mac.com> wrote in message
news:efab0c09-a4a4-4860...@h34g2000yqm.googlegroups.com...
.
The bush,jr administration was incompetent to deal with it or they
were in collusion with the thieves.
40 complaints....no response!
Werner
> "Werner" <whetz...@mac.com> wrote in message
Medicare fraud predates Bush. It's as old as Medicare.
Werner
> On Sat, 14 Nov 2009 13:48:55 -0800, Dom wrote:
> >http://news.yahoo.com/s/ap/20091114/ap_on_bi_ge/us_medicare_fraud
>
> > Govt: Medicare paid $47 billion in suspect claims By HOPE YEN,
> > Associated Press Writer Hope Yen, Associated Press Writer
> > Sat Nov 14, 12:11 pm ET
>
> > WASHINGTON – The government paid more than $47 billion in questionable
> > Medicare claims including medical treatment showing little relation to a
> > patient's condition, wasting taxpayer dollars at a rate nearly three
> > times the previous year.
>
> Because in previous years the Republican administration never cared to do
> anything other than whine about how social insurance systems cost the
> taxpayers bug bucks. The idea of documenting, publicizing, and policing
> was never given a thought.
>
Why limit your scorn?
http://nysl.nysed.gov/uhtbin/cgisirsi/Lu7tXsl7S7/NYSL/243850018/523/73893
yet
http://www.nytimes.com/2005/07/18/nyregion/18medicaid.html?ex=1279339200&en=b7bf75d8d29b6c0b&ei=5088&partner=rssnyt&emc=rss
do a search 'medicare fraud xxxx' where xxxx is any year.
Dom
> On Nov 14, 4:48 pm, Dom <DR...@teikyopost.edu> wrote:
>
> >http://news.yahoo.com/s/ap/20091114/ap_on_bi_ge/us_medicare_fraud
>
> > Govt: Medicare paid $47 billion in suspect claims
> >...
>
> Dollars in the common treasury are like fish in the common sea -
> anyone who can will harvest to extinction. That is why socialism is
> fundamentally corrupting and can not work.
In contrast to the Free Plunder System which works so "efficiently"!
Michael Coburn
> On Nov 14, 8:13 pm, Michael Coburn <mik...@verizon.net> wrote:
>> On Sat, 14 Nov 2009 13:48:55 -0800, Dom wrote:
>> >http://news.yahoo.com/s/ap/20091114/ap_on_bi_ge/us_medicare_fraud
>>
>> > Govt: Medicare paid $47 billion in suspect claims By HOPE YEN,
>> > Associated Press Writer Hope Yen, Associated Press Writer Sat Nov 14,
>> > 12:11 pm ET
>>
>> > WASHINGTON – The government paid more than $47 billion in
>> > questionable Medicare claims including medical treatment showing
>> > little relation to a patient's condition, wasting taxpayer dollars at
>> > a rate nearly three times the previous year.
>>
>> Because in previous years the Republican administration never cared to
>> do anything other than whine about how social insurance systems cost
>> the taxpayers bug bucks. The idea of documenting, publicizing, and
>> policing was never given a thought.
>>
>> ...
>
> Why limit your scorn?
> http://nysl.nysed.gov/uhtbin/cgisirsi/Lu7tXsl7S7/
NYSL/243850018/523/73893
> yet
> http://www.nytimes.com/2005/07/18/nyregion/18medicaid.html?
ex=1279339200&en=b7bf75d8d29b6c0b&ei=5088&partner=rssnyt&emc=rss
>
> do a search 'medicare fraud xxxx' where xxxx is any year.
From one of your quoted articles:
"After The New York Times discovered her extraordinary billings through a
computer analysis and questioned the state about them, Dr. Rosen and two
associates were indicted on charges of stealing more than $1 million from
the program."
The question arises as to why such analysis is not conducted by those who
run the system? And Obama is in the process of doing EXACTLY THAT.
Conservatives _HATE_ (oops, I mean FEAR) technology and progress.
Werner
They are not worth having.