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View Diary: Feds charge 91 people in $430 million Medicare fraud scheme (89 comments)

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  •  The problem is that while some may go to (8+ / 0-)

    prison, the bulk of the money will never be recouped. That came out of all of our pockets. We should all be mad as hell!

    It's really a bad mark for the Medicare Administration. That much money should never have been paid out. Where were the adjusters, accounting and the the others who should have prevented it from happening in the first place.

    This is poor management and poor systems. Not enough oversight. I was a health insurance adjuster many years ago. This would have been caught at the onset.

    There's something wrong with the system that allows this much money to be stolen from us.

    Sorry, as much as I love and need my Medicare (and I do), this story makes me bloody mad!

    It’s the Supreme Court, stupid! Followed by: It's always the Supreme Court! Progressives will win only when we convince a majority that they, too, are Progressive.

    by auapplemac on Sat Oct 06, 2012 at 09:12:10 PM PDT

    [ Parent ]

    •  Prevention and enforcement are underfunded (13+ / 0-)

      throughout the government. The IRS, SEC, etc., don't have the resources to do their jobs effectively. And they've been underfunded for years.

      Something else to thank Grover Norquist for.

      "We have created a Star Wars civilization, with Stone Age emotions, medieval institutions, and godlike technology."-Edward O. Wilson, in "The Social Conquest of Earth"

      by sparkysgal on Sat Oct 06, 2012 at 09:27:32 PM PDT

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      •  Trillions for the Military Industrial Complex! (5+ / 0-)

        No regulation for banks, fraudster financiers, stock swindlers, insider dealers, etc.

        Budget cuts for regulators, fraud investigators, etc.

        Sense a pattern?

        Eradicate magical thinking

        by Zinman on Sat Oct 06, 2012 at 10:26:53 PM PDT

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        •  No charges against the lying war criminals (0+ / 0-)

          No repealing the unconstitutional legislation passed under Dumbya and also used under Obama.

          Gee....  What's the point of having a DoJ...?

          I forget.  Wait.  Wait.  Don't tell me....

          I'm sick of attempts to steer this nation from principles evolved in The Age of Reason to hallucinations derived from illiterate herdsmen. ~ Crashing Vor

          by NonnyO on Sun Oct 07, 2012 at 02:02:33 AM PDT

          [ Parent ]

    •  How Medicare $ is disbursed is changing (2+ / 0-)
      Recommended by:
      sethtriggs, ladybug53

      So actually they are trying to prevent unqualified pre payment. Here is a story from NPR a coulple moths ago that talks about fraud fighting

      (Sorry, I don't think my iPod creates an easy hyperlink to the story for all computing devices so you might find the link is funky. If so search for NPR Medicare fraud)

      •  Obamacare computer upgrade requirements - fraud (5+ / 0-)
        But if crooks are smart, it may turn out that computers are smarter. The federal health law and other legislation directed the federal government to start using sophisticated anti-fraud computer systems. Budetti said the systems, which are being used first with Medicare, are similar to those used by credit card companies to detect suspicious purchases.

        "We're able to now verify whether a person was being treated by two different physicians in two different states on the same day or a variety of other possibilities," he said.

        The computer program crawls around the heaps of Medicare claims — some 4 million a day — to look for outliers: spikes in prosthetics in Miami or heart stents in Missoula. And for the first time, doctors and others who want to bill Medicare are being assessed based on their risk to commit fraud. Those who seem crooked are kept out.

        Lou Saccoccio, head of the National Health Care Anti-Fraud Association, said the aggressive computer systems and the government's new authority to suspend payments signal an important change at the Centers for Medicare and Medicaid Services.

        (Noodles' npr link didn't give much information so I thought this quote might show that Obamacare has led directly to additional fraud resources. Fraud prosecutions have a multiplier effect - other fraudsters may conclude that their odds of getting caught have increased and decide to get out of the business.)

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