A Drop in the Fraud Bucket

Bucket

The WSJ reported this morning more than 200 people have been charged in the largest crackdown on suspected Medicare fraud to date. The alleged false billing amounted to $712 million. —amounting to roughly $712 million in allegedly false billing, officials said Thursday.

Fraud-enforcement officials estimate 10% of Medicare’s yearly spending, more than $57 billion in 2013, was in bogus payments to healthcare providers, and the U.S. government recovered just $2.86 billion in Medicare funds that year. Congress recently mandated Medicare claims must be paid within 30 days of receipt, making it harder for The Centers for Medicare & Medicaid Services (CMS) to slow down payment to suspected fraudsters.

Healthcare fraud is rampant and has been very difficult to stop, but CMS is making some progress. The $712 million reported today is just alleged. Proving the fraud and reclaiming the money will take a lot of time and effort. If they get it all back, it will be just one percent of the annual fraud. Read about the sources of fraud and the specific techniques being used in Health Attitude.


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