Lawmakers Target Medicare and Medicaid Fraud
The Wall Street Journal, October 28th, 2009
The federal government needs to further step up efforts to fight
Medicare and Medicaid fraud to generate more savings to help pay for a
health-care overhaul, lawmakers said Wednesday.
"The scale of health care fraud in America today is staggering,"
Senate Judiciary Committee Chairman Patrick Leahy (D., Vt.) said at a
hearing. "Now, as health care reform moves through the Senate, I want
to make sure we do all we can to tackle the fraud that could undermine
efforts to reduce the skyrocketing cost of health care."
Health-overhaul legislation moving through Congress contains
provisions to beef up the government's antifraud effort. The U.S. loses
at least $60 billion to health-care fraud every year, and some
estimates put the cost as high as 10% of the nation's total health-care
spending, which exceeds $2 trillion. Medicare, the federal insurance
program for the elderly and disabled, and Medicaid, the federal-state
program for the poor, are especially susceptible. The government has
announced a series of indictments on Medicare and Medicaid fraud in the
past two years, including indictments earlier this week involving a
Mississippi medical clinic.
Sen. John Cornyn (R., Texas) said government officials still need to
figure out why Medicare and Medicaid have a higher rate of fraud than
private insurers, especially since Congress is considering creating a
public-insurance program. "I'm sure we'll never have enough good guys
to outnumber the bad guys in this area." Mr. Cornyn said, asking Health
and Human Services and Justice Department officials: "What can you do
to reduce it?"
Bill Corr, deputy HHS secretary, said HHS and the Justice Department
are making progress, especially by using specialized teams to ferret
out fraud. But he agreed that the task is huge. Medicare alone, he
testified, receives 4.4 million claims each day, which have to be paid
between 14 and 30 days.
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