So, just like patients, doctors are fully capable of committing scams. I read today about a big one HERE. A medical group in Queens, NY was basically offering Medicare patients all sorts of perks (dance lessons, massages, etc) if they let the providers bill Medicare for services that were not performed on them. In fact, over the years, the cost to the government and tax payers was 95 million!!! As is fortunately often the case, they finally got busted. Dr Kim and company were indicted in this massive scheme.
I find this sort of thing so reprehensible I can barely contain myself. Continuing to shut these scams is a way we can save lots of healthcare dollars. It’s also why we (legitimate providers) suffer under all these regulations. Otherwise fraud would be even more rampant than it is.
03
Nov
Doc says “It’s also why we (legitimate providers) suffer under all these regulations.” But, your suffering is for naught, because the regulations are mostly for show.
How to Stop Medicaid Fraud – For starters, states should try
March 2006 – City-Hournal by Steven Malanga
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[edited excerpt] Neither the feds nor the states accompanied the huge Medicare spending increases with additional resources for fraud detection. Many programs spend derisory sums on enforcement. Over half of states now spend less than 1/1000th of their Medicaid budgets to fight fraud. New York cut its fraud department from 200 in the late 1980′s to 50 by 2005, as payments grew to $30 billion.
Several states still use decrepit eighties-era software to try to track hundreds of millions of yearly Medicaid claims. 14 out of 53 state and local Medicaid programs employ no experts to detect fraud and waste.
Federal supervision is almost nonexistent. The federal agency responsible for overseeing Medicaid anti-fraud initiatives employs eight people with a budget of $26,000 (apart from salaries).
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Ironically, private insurers spend a much higher percentage of payments tracking fraud, and they are blamed for this higher administrative cost than government incurs. But, fraudulent payments are excluded from this analysis. Politicians do not want a large fraud department. What they don’t discover cannot be blamed on their bad, public administration of medicine.