Medicare pays upwards of $60 billion per year to con artists who defraud the federal government in what has become a quick, easy and relatively undetectable crime, even while lawmakers say that the problem could be stemmed by removing beneficiaries Social Security numbers from their coverage cards and developing a claims-verification process.
Quite simply, Medicare is not sophisticated enough to address the fraud that runs rampant through it, Sen. John Cornyn (R-Texas) said during a Senate Republican Conference meeting. Every year, Medicares anemic fraud control lets slip by an array of schemes that cost the Medicare program and taxpayers $60 billion, if not more.
A conference committee report cited a number of cases where Medicare was taken for millions of dollars, including instances where medical devices were billed multiple times and medications ordered with no intent of ever reaching a patient. In one case, a person in Miami was able to get $5 million from the Medicare program for an electric wheelchair, according to the report.
Cornyn warned that the low risk, high reward fraud and abuse of Medicare has helped the program inch closer to bankruptcy, adding that the system needs to move from a pay and chase model to one of protect and prevent.
Cornyn and Sen. Mel Martinez (D-Fla.) have sponsored legislation which, in part, would require Medicare to stop using Social Security numbers as the Medicare Beneficiary Identifier.
Lewis Morris, chief counsel in HHS inspector generals office, in describing why it has become so easy to bilk Medicare, said that the CMS has worked very hard to be provider friendly, adding that the agency is biased in favor of making payments.
The CMS reviews less than 2% of the claims it receives each year, Morris said. -- by Matthew DoBias
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