• Please keep all posts on the Rittenhouse verdict here: Rittenhouse Verdict. Note the moderator warnings in the thread. The thread will be heavily moderated with a zero tolerance policy for any baiting, flaming, trolling or other rule breaks. Stick to the topic and not the other posters. Thank you.
  • This is a political forum that is non-biased/non-partisan and treats every person's position on topics equally. This debate forum is not aligned to any political party. In today's politics, many ideas are split between and even within all the political parties. Often we find ourselves agreeing on one platform but some topics break our mold. We are here to discuss them in a civil political debate. If this is your first visit to our political forums, be sure to check out the RULES. Registering for debate politics is necessary before posting. Register today to participate - it's free!

Can we Stop Medicare Fraud?

Mustachio

DP Veteran
Joined
Jul 31, 2010
Messages
3,992
Reaction score
1,920
Location
Minneapolis
Gender
Male
Political Leaning
Other
Medicare costs have exceeded $500 billion a year. Now, I pose this question because I nearly vomit every day when I see the countless commercials on TV advertising medical devices "at no cost to you!" In case you don't know, these advertisements are all over and the idea is that they tell seniors to call them to acquire some product, like a wheelchair, and it will be free. It's "free" for seniors because they have medicare, so these companies then bill medicare (often billing them way more than should be legal IMHO). So my conundrum is whether or not this kind of advertising should even be legal.

Yes, seniors need proper medical coverage and medicare allows retired people to live out their days with a safety net. It also ensures they stay healthy, and it makes their lives better and longer. So I'm all for people getting the care they need. But should companies really be allowed to do this? By saying "hey, seniors, get this product because it's free." Isn't that like saying "who cares if you need it? It's free!!" That's just stealing from the government. The whole thing just makes me sick.

A little background. From Wikipedia's lovely "Medicare Fraud" page, the different ways people defraud medicare:

  1. Phantom Billing: The medical provider bills Medicare for unnecessary procedures, or procedures that are never performed; for unnecessary medical tests or tests never performed; for unnecessary equipment; or equipment that is billed as new but is, in fact, used.
  2. Patient Billing: A patient who is in on the scam provides his or her Medicare number in exchange for kickbacks. The provider bills Medicare for any reason and the patient is told to admit that he or she indeed received the medical treatment.
  3. Upcoding scheme and unbundling: Inflating bills by using a billing code that indicates the patient needs expensive procedures.

A recent case of exactly what I'm walking about: Medicare fraud crackdown hits Texas maker of powered wheelchairs « Watchdog.org
 

Paschendale

Uncanny
DP Veteran
Joined
Nov 3, 2010
Messages
12,510
Reaction score
12,604
Location
New York City
Gender
Male
Political Leaning
Socialist
Sure. All we need to do is regulate how much those companies can charge. Refuse to let them mark their crap up.

But for all of those three specific situations, those are at least actual fraud and simply need more oversight to catch and prosecute.
 

specklebang

Discount Philosopher
DP Veteran
Joined
Jan 13, 2012
Messages
11,524
Reaction score
6,769
Location
Las Vegas
Gender
Undisclosed
Political Leaning
Other
Unfortunately, the first amendment has empowered a wave of advertising of medications, shady lawyer and free phone ads (I got one in the mail last week) with no end in sight to the range of possibilities.

I chose a Medicare PFFS plan for 2013. It worked fine until April 1, when my chiropractor showed me a letter freezing my plan. Turns out some MD started the plan, collected millions in prepaid medicare funds (you pay the government $103.50 a month plus your plan fee. The government pays the insurance more in advance. The guy took the money and ran.

Seems that being a Doctor doesn't make you honest. Like the war on drugs, the audits of the IRS, the failure of Everify, it's all just a game of whack-a-mole. Sure, they could hire a few thousand detectives to rummage through every medical practice (or welfare claim, or disability claim or...) but they won't. Money is the most powerful drug of all.





Medicare costs have exceeded $500 billion a year. Now, I pose this question because I nearly vomit every day when I see the countless commercials on TV advertising medical devices "at no cost to you!" In case you don't know, these advertisements are all over and the idea is that they tell seniors to call them to acquire some product, like a wheelchair, and it will be free. It's "free" for seniors because they have medicare, so these companies then bill medicare (often billing them way more than should be legal IMHO). So my conundrum is whether or not this kind of advertising should even be legal.

Yes, seniors need proper medical coverage and medicare allows retired people to live out their days with a safety net. It also ensures they stay healthy, and it makes their lives better and longer. So I'm all for people getting the care they need. But should companies really be allowed to do this? By saying "hey, seniors, get this product because it's free." Isn't that like saying "who cares if you need it? It's free!!" That's just stealing from the government. The whole thing just makes me sick.

A little background. From Wikipedia's lovely "Medicare Fraud" page, the different ways people defraud medicare:

  1. Phantom Billing: The medical provider bills Medicare for unnecessary procedures, or procedures that are never performed; for unnecessary medical tests or tests never performed; for unnecessary equipment; or equipment that is billed as new but is, in fact, used.
  2. Patient Billing: A patient who is in on the scam provides his or her Medicare number in exchange for kickbacks. The provider bills Medicare for any reason and the patient is told to admit that he or she indeed received the medical treatment.
  3. Upcoding scheme and unbundling: Inflating bills by using a billing code that indicates the patient needs expensive procedures.

A recent case of exactly what I'm walking about: Medicare fraud crackdown hits Texas maker of powered wheelchairs « Watchdog.org
 

cpwill

DP Veteran
Joined
Dec 20, 2009
Messages
68,033
Reaction score
34,531
Location
USofA
Gender
Male
Political Leaning
Conservative
Absolutely we can. The problem at current is that no one has a motive to do so. That is part of why restructuring Medicare needs to involve putting the money in the hands of the patients so that they have a vested interest in insuring that their numbers are not abused.
 

Crosscheck

DP Veteran
Joined
Dec 15, 2009
Messages
12,008
Reaction score
9,390
Location
NW USA
Gender
Male
Political Leaning
Undisclosed
About time the Scooter Store was exposed. Their ads often told seniors they wouldn't have to pay a dime.

Somebody better be going to prison.
 

274ina

DP Veteran
Joined
Jun 14, 2012
Messages
4,415
Reaction score
641
Gender
Male
Political Leaning
Other
Yes it is very simple.

Eliminate the bill and fraud cant happen.

Universal Health Care.

This is Gov paid Dr's, with Gov paid FLAT RATE suppliers for the ignorant TEA Party bunch.
 

reinoe

DP Veteran
Joined
Jul 8, 2013
Messages
16,824
Reaction score
7,183
Location
Out West
Gender
Male
Political Leaning
Centrist
Sure. All we need to do is regulate how much those companies can charge. Refuse to let them mark their crap up.

But for all of those three specific situations, those are at least actual fraud and simply need more oversight to catch and prosecute.
Medicare already regulates how much companies charge.
 
Top Bottom