Why We Are Losing the War on Fraud
Regulators fighting an estimated $60 billion to $90 billion a year in Medicare fraud frequently suspend Medicare providers, then quickly reinstate them after appeals hearings that government employees don’t even attend, according to an Associated Press review. Federal prosecutors say the speedy reinstatements — though helpful to legitimate suppliers who get snagged on technicalities or minor violations — amount to a missed chance to cut off the flow of taxpayer dollars to bogus companies that in many cases wind up under indictment.
We are losing because the scam artists are so much smarter than the people running the government.
No surprise here.
But wait a minute… because Medicare has lower overhead, aren’t we often reminded how efficient Medicare is when compared to private insurers? I wonder if private insurers spend some of their overhead on billing management, claims validation and fraud control?