Since 2000, Medicare has paid out as much as $92 million to DME providers for equipment prescribed by doctors who were dead at the time, a Congressional investigation has found. During that period, CMS paid about 500,000 such claims, despite becoming aware of this form of fraud in 2001 when the HHS Office of the Inspector General identified it. This report is part of a broader investigation into Medicare waste, abuse and fraud being conducted by the Senate Homeland Security and Governmental Affairs Committee's subcommittee on investigations.
Investigators discovered the problem when they ran a check matching American Medical Association lists of physicians who died between 1992 and 2002. They randomly selected 1,500 of the deceased physicians, then checked Medicare claims filed between 2000 and 2007 for those doctors' Medicare ID numbers. During that period, ID numbers for 734 dead doctors were used to file 21,458 claims totaling $3.4 million. Using these numbers, investigators estimated that 384,730 to 572,238 such illegal claims were submitted during that period. They also noted that there are still active ID numbers in the Medicare system for up to 2,895 physicians, leaving the door open for future fraud.
To learn more about the investigation:
- read this Washington Post piece
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