KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Combating Medicare Fraud Proves To Be A Difficult Proposition

The New York Times reports that, despite stepped-up enforcement and investments in anti-fraud efforts, the administration's push has so far not made much progress. Meanwhile, The Washington Post examines a classic Medicare scam.

The New York Times: Pervasive Medicare Fraud Proves Hard To Stop
The Obama administration’s declared war on health care fraud, costing some $600 million a year, has a remarkable new look in places like Baltimore and Miami. But even with the fancy computers and expert teams, the government is not close to defeating the fraudsters. And even the effort designed to combat the fraud may be in large part to blame. An array of outside contractors used by the government is poorly managed, rife with conflicts of interest and vulnerable to political winds (Abelson and Lichtblau, 8/15).

The Washington Post: A Medicare Scam That Just Kept Rolling
The wheelchair scam was designed to exploit blind spots in Medicare, which often pays insurance claims without checking them first. Criminals disguised themselves as medical-supply companies. They ginned up bogus bills, saying they’d provided expensive wheelchairs to Medicare patients — who, in reality, didn’t need wheelchairs at all. Then the scammers asked Medicare to pay them back, so they could pocket the huge markup that the government paid on each chair. A lot of the time, Medicare was fooled. The government paid (Fahrenthold, 8/16).

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