The Face of Medicare Fraud

I have heard over the last couple of years a number of ideas about why the Patient Protection and Affordable Care Act, affectionately known as Obamacare by its enemies (side note — if you hear someone refer to it as this, you can be assured that their arguments will be heavily one-sided and based more on talking points than reality) is a bad idea. Some of them include the notion that people will, out of greed, opt to pay a penalty for not having insurance and then get it when they absolutely need to do so based on knowing they will not be denied due to a pre-existing condition. Another is the argument that since Medicare is bloated and not functioning as is, introducing reform will do nothing to help it.

I would like to introduce you to the face of the real problem and it is a doctor in Texas. Specifically, this doctor allegedly took nearly four hundred million dollars fraudulently from Medicare in a variety of ways. Homeless people were recruited to fill forms that were then submitted to Medicare and generated income for the doctor. This was in addition to door to door canvassing that the doctor performed in an effort to get money from Medicare fraudulently.

What is rather unfortunate is that this is only one drop in an enormous bucket of Medicare fraud. We can only imagine that there are numerous other doctors who are also taking advantage of the system in a similar manner. If a person gets away with it once and they see that they are getting money for not a lot of work, and then they try it again and see that it continues to get them money, why stop?

What I do not understand is how, if the doctor really got this much money from Medicare, he only faces being fined two hundred and fifty thousand dollars. What is going to happen to the hundreds of millions of dollars that were stolen from honest hard working taxpayers? I would think that every dollar should be accounted and repaid.

I think that this kind of crime should not be punished with prison but with a long sentence of pro bono work, perhaps even full time work in a completely free clinic. This way the doctor’s natural talents would continue helping people in need while teaching him a valuable lesson about what his priorities should be.

6 comments

  • I hope, with the new use of electronic documents and processing, the Feds will be better able to spot these thefts in real time instead of having to cope with a mound of paper. This sort of fraud should be routinely caught before it can actually begin.

    • I hope so as well! It really should be automatically detected when a person submits an unusual number of requests like that.

      • Right! Auto-flagged as suspicious activity. If our credit card companies can do that — so should the Feds!

        • I went to the bank one day and made three legitimate transactions at the ATM. They immediately flagged it and called me to discuss it with me. Small beans compared to what the thieves get away with toward Medicare.

          • Every third iTunes purchase I make, my credit card company cuts me off. They don’t call. They just deny the purchase as “fraudulent activity” and I have to call in and re-confirm my identity and my account, and then approve the purchase. It’s madness!

          • If I were in your position I would just purchase $50 itunes cards and just run through those rather than do buy by buy. (Bye bye bye?)

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