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June 29, 2015

Urgency of Rising Medicare Fraud

Summary:

If there are doctors and nurses committing hundreds of millions of dollars of Medicare fraud, then they are targeting self-insureds, too.

Photo Courtesy of Picture of Money

Ho-hum: The FBI arrested 46 doctors and nurses…largest Medicare fraud bust ever.

That is from a headline in a recent CNN story. Seems the thieving doctors and nurses got away with $712 million before getting busted.

Per the story, “In total, 243 people were arrested in 17 cities for allegedly billing Medicare for $712 million worth of patient care that was never given or unnecessary.”

Note the word “unnecessary.” If there are doctors and nurses doing this to Medicare patients, they are defrauding self-insured benefit plan patients, too.

This has been getting worse and worse every year for 20 or so years. I say “ho-hum” at the beginning of this post because almost no one in the private sector takes stopping this kind of thing seriously. There is a lot of talk and little action.

I urge readers to start taking steps to stop this mess.

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About the Author

Tom Emerick is president of Emerick Consulting and cofounder of EdisonHealth and Thera Advisors.  Emerick’s years with Wal-Mart Stores, Burger King, British Petroleum and American Fidelity Assurance have provided him with an excellent blend of experience and contacts.

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