I post at a number of left wing blogs and I was amazed few of them either had watched this, heard of this, or admitted that fraud is a huge issue with Medicare.
I contacted both my Senators and my Rep in Congress staffers and none of them had heard this report.
Our left wing media at work; Stephoupolis, Gibson, and the other “news” anchors never even brought it up.
Abt 15 years ago, I watched a Congressman on one of the network news program. He was being asked about SS/Medicare fraud and why the Govt didn’t do more to combat it.
His response: It would cost more to combat the fraud than the actual amount of the fraud is.
[Hey, Congressman, that’s OUR money! But, that is governmenthink.]
So -essentially, government fraud in the health care system is nearly 10 times the annual profit of the insurance industry... nice.
That is because profit oriented insurance companies have a vested interest in fighting fraud, whereas the govt. spends next to nothing to combat it. The government has no motive.....it ain’t their money being squandered. It’s OURS!
This is all very important stuff, but let me tell you about the MISTAKES that the GOVERNMENT makes, all the time, in Medicare:
1.) Medicare Part “B” late enrollment penalties. There is a penalty of 10% of the base, Part B Premium, for every year that a qualified beneficiary does not sign up for Part “B” of Medicare. This Penalty is WAIVED for those who have group insurance, through an employer or spousal coverage. The government ROUTINELY charges Medicare beneficiaries who do NOT owe this “penalty” -— primarily due to incompetence on the part of the officials who sign people up for Medicare.
2.) Part “D” Prescription Drug coverage has a penalty for late enrollment, as well. That penalty is 1% of the base, average premium, for every month the beneficiary did not have Part “D” or “credible coverage” with a group health insurance plan. Those who retire at age 66 or later ROUTINELY have to fight this penalty, even if they never went a day without Prescription Drug coverage.
3.) Your government at work: I have had clients receive letters, from the government, which denied a medical claim due to Medicare being “secondary” and not “primary” -— This means that the government thought a group plan was STILL in force for this person. -— IN THE SAME WEEK, this client ALSO received a letter from CMS, the Center for Medicare and Medicaid Services, saying that this client would have to pay a PENALTY on Part D, due to A LAPSE IN DRUG COVERAGE!
Get it? The Left hand of government slaps them for having group insurance, though it does not exist anymore, while the Right hand of government slaps them for never having the group insurance that a previous letter, from the government, CLEARLY documented that they HAD! This person never missed a day of health coverage, never went “uninsured” but had to spend a couple of hours on the phone, with my help, to clear this up. THIS HAPPENS ALL THE TIME!!
Yes, I am a health insurance agent.
Pray for me!
Medicare benefits are disbursed by private insurance carriers, under government contracts.
Contracted Insurance carriers have no pressure to monitor income vs. outcome. It’s not their money, their policy holders’ or investors’ money - it is just *tax payers’* money.
The fraud or accounting mishaps are perpetrated by careless claims payment, gimmee patients, over-worked physicians, hospital ER burdens, scooter vendors and drug companies in the form of overly cautious testing and over-billing. Plus, Government bureaucracy & oversight is pathetic or non-existant.
How does an individual defraud medicare? I can see doctors, health care providers and insurance companies being able to but how does the patient do it?
I expect those people are in the process of getting a very real lesson in what it is that makes a country able to stay safe and sound.
These numbers are eye-opening. I wonder, though, how much insurance fraud is there committed against the top ten companies. The fraud numbers make a case for patients paying there own bills, at least for routine office visits. Why can we no longer get hospitalization insurance that covers only the big bills?
Bookmark.
The list, ping