Medicare fraud cuts disputed by IG

In 2006, CMS said that it had managed to cut the level of Medicare fraud by billions of dollars, and basked in the praise of lawmakers who commended the agency's good stewardship. The problem: the gains may have been an illusion, or arguably, a deliberate deception. That, at least, is the conclusion drawn by the HHS Inspector General's office, according to a confidential draft of a report investigating Medicare fraud-fighting.

According to the IG, Medicare officials engaged in questionable methods when they calculated fraud levels. For example, they instructed auditors not to compare invoices submitted by salespeople against doctors' records to make sure that medical equipment actually went to patients. (This step is required by law.) Because they didn't take this step, Medicare officials missed more than one-third of improper spending for wheelchairs, oxygen supplies and other medical equipment for fiscal 2006. That accounts for about $2.8 billion in improper spending, negating the $700 million for which officials took credit. Now, some members of Congress are outraged, and say that they're not sure they can trust other Medicare figures either. (Can't say I blame them!)

To learn more about the IG's report:
- read this piece from The New York Times

Related Articles:
Medicare fraud costs CMS billions
Fraud riddles FL medical device firms
CMS: RAC program has recovered more than $1B
HFMA ANI 2008: Advice on preparing for a Medicare audit

Suggested Articles

The profit margins and management of Community Health Group raise questions about oversight of managed care insurers.

Financial experts are warning practices about the pitfalls of promoting medical credit cards to their patients.

A proposed rule issued by HHS on Tuesday would expand short-term coverage, a move Seema Verma said will have "virtually no impact" on ACA premiums.