Can we Stop Medicare Fraud?

[Mustachio]

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]

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]

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]

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]

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]

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]

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.