Probe: Medicare paid billions in suspect claims

Source: AP

WASHINGTON (AP) — The government paid more than $1 billion in questionable Medicare claims for medical supplies that showed little relation to a patient's condition, including blood glucose strips for sexual impotence and special diabetic shoes for leg amputees, congressional investigators say.

Billions more in taxpayer dollars may have been wasted over the last decade because the government-run health program for the elderly and disabled paid out claims with blank or invalid diagnosis codes, such as a "?" or "zzzzz." Medicare officials say even smiley-face icons could have been accepted.

The report by Republicans* on the Senate Homeland Security investigations subcommittee, obtained by The Associated Press, is the latest to detail lax oversight in the $400 billion program that has been cited by government auditors as a high-risk for fraud and waste for nearly 20 years.

CMS has acknowledged that its medical equipment program is susceptible to fraud and waste, estimating in 2007 that $1 billion of the roughly $10 billion in Medicare payments over a one-year period were improper. A recent report by the HHS inspector general suggested that annual waste could actually be as high as $2.8 billion, citing particularly shoddy government oversight.

Read more: http://ap.google.com/article/ALeqM5jaD627V_u_hm4koV2o-2DYuICCDgD93CSE480

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* FROM the article (last paragraph)

The Senate investigation was conducted by both Democratic and Republican committee staff. Sen. Carl Levin, D-Mich., who chairs the subcommittee, declined to sign onto the final report, citing lack of time for review due partly to congressional efforts in the Wall Street bailout.

it would absolutely not to be susceptible to fraud and waste.

:rofl:

but all of these programs need MUCH better oversight.

HCA was founded and still partially owned by former Sen. Bill Frist's family.


http://seniorhealth.about.com/library/weekly/aa121700a.htm
A Department of Justice investigation that started when an employee found questionable documents in the dumpster behind an El Paso, TX hospital ended December 14 when the largest fraud settlement in US history was announced. Attorney General Janet Reno announced the settlement in a Washington press conference, citing this as victory against those unscrupulous health care providers who would take taxpayer money that does not rightly belong to them.

In her statement, the Attorney General stated, "Under a civil settlement, HCA -The Healthcare Company will pay $745 million, plus interest, for its alleged false billing practices. And, it will pay $95 million in criminal fines.

HCA Settles Utah Allegations of Medicare Fraud for $857,000.
http://findarticles.com/p/articles/mi_hb5553/is_200402/ai_n22113265
Knight Ridder/Tribune Business News, February, 2004

Media reports on Frist stock sale investigation largely omit company's history of fraud
http://mediamatters.org/items/200510070002
Fri, Oct 7, 2005

Margaret Wynne Harrison, Fraud & Abuse, "Two Columbia/HCA Executives Found Guilty of Fraud"
http://www.aslme.org/news/jlme/27.3d.html
On July 2, 1999, a Florida federal jury, in United States v. Jarrell, No. 97-52-CR-FTM-24 (D) (M.D. Fla. July 2, 1999), found two Columbia/HCA executives guilty on six counts of Medicare fraud and conspiracy. These were the first convictions of Columbia/HCA executives in connection with the government's Medicare fraud investigations. Health care providers and law enforcement officials throughout the United States followed the case closely, because many saw its outcome as predicative of the course of the government's other criminal cases against Columbia/HCA and its executives. The verdict also likely will give the government leverage in its ongoing settlement negotiations with Columbia/HCA on the various Medicare fraud civil cases still pending. On a broader level, the case sends a warning to the rest of the industry about the importance of compliance with the complex Medicare cost-reporting regulations. Finally, the verdict could influence the hospital industry's lobbying for relaxation of the 1997 Balanced Budget Act's (BBA) strict limits on Medicare's reimbursement of hospital expenditures.

whose philosophy is to trash government agencies and then hold it up as proof that they don't work.

When we throw the bums out we can begin the work of making our government function again.