$225 Million Medicare Fraud Exposed

The arrests are the latest in a string of major busts in the past two years as authorities have struggled to pare the fraud that’s believed to cost the government between $60 billion and $90 billion each year. Stopping Medicare’s budget from hemorrhaging that money will be key to paying for President Barack Obama’s health care overhaul. — from AP

In Miami, two doctors and several nurses from ABC Home Health Care Inc. were arrested and charged for writing prescriptions for services that were never given, totaling $25 million.

For decades, Medicare has operated under a pay-and-chase system, paying providers first and investigating suspicious claims later. The system worked when the agency was paying hospitals and institutions that couldn’t close up shop and flee the country if they’d been overpaid. But as Medicare has expanded to one of the largest payer systems in the world, he agency has struggled to weed out crooks. There are about 1.3 million licensed suppliers nationwide with 18,000 new applications coming in every month.

“We can arrest and charge people every day and it still won’t make a dent until changes are made to Medicare,” said FBI special agent in charge John Gillies. — from AP

Resources:
AP: 111 charged in Medicare scams worth $225 million
CNN: Doctors, nurses, execs among record number charged with Medicare fraud