Medicare officials don't plan to investigate $ billions in fraud

According to a new Inspector General’s report, Medicare lost 6.7 billion dollars to fraud and error in 2010, and I would venture a wild guess that the annual figure has grown since then.  Charles Ornstein of NPR explains the source of a lot of that theft:

The inspector general's report, released today, estimates that overpayments account for 21 percent of the $32.3 billion spent on evaluation and management services in 2010. The evaluation and management category includes office visits, emergency room assessments and inpatient hospital evaluations.

This is the second time that the inspector general has singled out this area for more scrutiny. In 2012, the watchdog said physicians had increasingly billed Medicare for more intense — and more expensive — office visits over time. But that didn't prove the claims were improper.

"The natural question that comes out of this is: Are these physicians billing appropriately?" said Dwayne Grant, regional inspector general for evaluation and inspections in the Atlanta region, who oversaw the new report. "We don't want to pay them too much but we don't want to pay them too little either."

For this review, the inspector general gathered the medical records associated with 657 Medicare claims and asked professional coders to see whether the records justified the rates charged.

Sounds like a pretty solid study.  So with billions of dollars  a year at stake, denying resources to people who need them and enriching thieves, it would seem pretty important to go after the malefactors of medicine. But apparently not:

But in its reply to the findings, the Centers for Medicare and Medicaid Services, which runs Medicare, said it doesn't plan to review the billings of doctors who almost always charge for the most expensive visits because it isn't cost-effective to do so.

As Walter Russell Meade of The American Interest puts it:

Medicare knows some doctors are ripping off taxpayers but lacks the ability or will to find out how bad the problem is, much less put a stop to it. If this is the glorious health care system we are building, God help us all.

Hat tip: Ed Lasky

 

According to a new Inspector General’s report, Medicare lost 6.7 billion dollars to fraud and error in 2010, and I would venture a wild guess that the annual figure has grown since then.  Charles Ornstein of NPR explains the source of a lot of that theft:

The inspector general's report, released today, estimates that overpayments account for 21 percent of the $32.3 billion spent on evaluation and management services in 2010. The evaluation and management category includes office visits, emergency room assessments and inpatient hospital evaluations.

This is the second time that the inspector general has singled out this area for more scrutiny. In 2012, the watchdog said physicians had increasingly billed Medicare for more intense — and more expensive — office visits over time. But that didn't prove the claims were improper.

"The natural question that comes out of this is: Are these physicians billing appropriately?" said Dwayne Grant, regional inspector general for evaluation and inspections in the Atlanta region, who oversaw the new report. "We don't want to pay them too much but we don't want to pay them too little either."

For this review, the inspector general gathered the medical records associated with 657 Medicare claims and asked professional coders to see whether the records justified the rates charged.

Sounds like a pretty solid study.  So with billions of dollars  a year at stake, denying resources to people who need them and enriching thieves, it would seem pretty important to go after the malefactors of medicine. But apparently not:

But in its reply to the findings, the Centers for Medicare and Medicaid Services, which runs Medicare, said it doesn't plan to review the billings of doctors who almost always charge for the most expensive visits because it isn't cost-effective to do so.

As Walter Russell Meade of The American Interest puts it:

Medicare knows some doctors are ripping off taxpayers but lacks the ability or will to find out how bad the problem is, much less put a stop to it. If this is the glorious health care system we are building, God help us all.

Hat tip: Ed Lasky

 

RECENT VIDEOS