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Posted on 07/10/2026 4:01:49 PM PDT by E. Pluribus Unum
Last year, we wrote in the Los Angeles Times that the Centers for Medicare and Medicaid Services was done chasing criminals after we’d already handed them money. We said we were building something different — a prevention-first operation that would detect and stop fraud before the check cleared, not attempt to claw back lost funds years later.
Skeptics had reason to doubt. Government agencies announce transformations all the time. The results usually don’t follow.
So here are the numbers:
In fiscal year 2025, Medicare savings from the prevention of fraud, waste and abuse hit $42 billion — an almost 60% increase over the prior year and the highest figure ever recorded in the program’s history. That’s not just a line on a spreadsheet. In Medicare’s coffers, $42 billion can pay for 3 million knee replacements, 7 million cataract removals or 37.5 million routine colonoscopies.
Finding and stopping fraud can be expensive, but return on investment also hit an all-time high — more than $22 saved for every dollar spent on program integrity.
And here’s the stat we’re proudest of: Nearly 70% of those savings came not from recovering money already out the door, but from prevention-first actions — revoking fraudulent providers before they could continue billing, stopping improper claims at the point of submission and intercepting payments through prepayment controls before they ever cleared.
We promised big changes. The scoreboard says the Centers for Medicare and Medicaid Services delivered.
One key to success has been to finally acknowledge the scale of the problem and adapt appropriately. Healthcare fraud spreads like wildfire. Left unchecked, a single bad actor can become a network, a network can become an industry, and billions of taxpayer dollars can go up in smoke.
Many of these schemes are run by organized criminal enterprises that rotate billing...
(Excerpt) Read more at latimes.com ...
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Medicare fraud? That’s a juicy nugget, but I’d bet dollars to donuts there is fraud in every department and program of the Federal government. It’ll take decades to root it out thoroughly and keep it at bay....will that happen....? Nah. When the economy finally implodes when the Feds default on the debt, then maybe the people will get a chance to right things, but at a huge, catastrophic cost. And then, maybe then, some public servants will be jailed or swinging from a light pole... Nah. Then I woke up.
If you don’t put them in jail, they are in a holding pattern, waiting for the next grab.
Also known as The democRAT/DemoKKKrat Party
RINOs also
will that happen....? Nah
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unless you use fable 5 and above level ai on the fraudsters.
“In Medicare’s coffers, $42 billion can pay for 3 million knee replacements, 7 million cataract removals or 37.5 million routine colonoscopies.”
Or, better yet, reduce EVERYBODY’s premiums!
so would you rather they do nothing? This is a good start, now we need to build on it
They should have used some of the savings to hire a human to write this article.
It won't happen because, sadly, there will be future Democrat administrations, and they'll look the other way again.
Oh well, at least they're finally doing something about it now.
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