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Medicare fraud outrageous and must be stopped | Sun Journal
Even a small percentage of fraud can add up to a very large number.
It’s like mugging grandma, then beating a taxpayer with a rubber hose.
Few things are more maddening than people stealing public benefits.
It’s doubly so when those people are medical professionals who could
be earning a handsome living by operating on the right side of the
law.
Wednesday, 700 law enforcement agents arrested more than 100 people
accused of stealing more than $225 million from Medicare. This was
only two days after 21 people were arrested in Miami for bilking
taxpayers out of $200 million.
The arrests are the latest in a series of busts over the past two
years intended to curb what authorities think is between $60 and $90
billion in fraud each year.
Ten years ago, it was widely believed that fraud was a relatively
small part of overall Medicare spending, perhaps in the range of 2 to
3 percent.
But Medicare and Medicaid cost taxpayers $800 billion in 2010 and
consumed 23 percent of the federal budget. So even a small percentage
of fraud can add up to a very large number.
Authorities estimate that 10 percent of Medicare and Medicaid payments
are fraudulent, meaning we could be losing $80 billion a year to
medical thieves, a serious sum, even by federal standards.
The 111 arrested Wednesday were doctors, nurses and physical
therapists in nine U.S. cities.
The spike in Medicare and Medicaid busts is welcome and long overdue,
and no part of the country should be spared.
Federal officials have, in fact, made several Medicare and Medicaid
fraud arrests locally, including the conviction of a Harrison woman
for stealing more than $4 million.
Her partially completed lakeside luxury home was auctioned to the
highest bidder last week to help offset what she stole from taxpayers.
Two things may account for the upswing in major medical fraud cases.
First, Medicare long operated as a “pay-and-chase” system which paid
providers first and investigated suspicious claims afterward.
That worked well when hospitals and other large providers were the
main recipients of Medicare funding.
As the program expanded and services became more dispersed, it became
easier for rogue operators to quickly set up shop, bill Medicare for a
few months, then shut down.
What’s clearly needed is more vigorous screening of providers before
they ever receive a Medicare or Medicaid payment and more rapid
detection of suspicious providers.
Second, we now seem to live in a society with tremendous income
inequality, which has allowed some Americans to live like proverbial
kings.
It is now, apparently, not enough to make four or five times as much
as the average working American. Some people only seem satisfied when
their annual incomes are measured in the millions, rather than
hundreds of thousands.
These are premeditated crimes committed by people smart enough to
weigh the risks and rewards.
That makes this an area where longer prison sentences, not just
probation, combined with tougher enforcement can have a significant
deterrent effect.
Taxpayers must demand these programs do better.
rrho...@sunjournal.com
The opinions expressed in this column reflect the views of the
ownership and editorial board.
http://www.sunjournal.com/our-view/story/1085300