Medicare Fraud Costs Billions of Dollars Each Year, CMS Officials Testify
Kaiser Daily Health Policy Report
April 19, 2007
Medicare fraud costs billions of dollars each year, according to testimony from federal officials at a Wednesday hearing of the House Energy and Commerce Subcommittee on Health, CongressDaily reports. Acting CMS Administrator Leslie Norwalk said, "The fraudulent business practices of unscrupulous durable medical equipment, orthotics, prosthetics and supplies suppliers continue to cost the Medicare program billions of dollars," adding that CMS "has seen a marked increase in fraud and abuse activities over the past few years that can be directly tied to provider enrollment issues." Examples of fraud include paying kickbacks to physicians who prescribe high-cost wheelchairs when lower-cost equipment would be effective and filing Medicare claims for equipment never delivered or not needed. Medicare and fraud prosecutions have resulted in $11 billion in fines and settlements since 1997, according to the testimony of Daniel Fridman, senior counsel to the attorney general. The HHS Office of Inspector General recently investigated Miami-Dade County, Fla., which has the highest concentration of equipment suppliers per Medicare beneficiary. Investigators conducted inspections of 1,581 sites and uncovered fraud that resulted in 286 suppliers losing Medicare eligibility. At the hearing, federal officials also testified that the rate of mistakes by Medicare that result in overpayments or other errors is dropping. Norwalk said new figures will indicate that the effort to reduce billing and other errors "has been a success." The error rate is on target to reach 4.3% in 2007, compared with 5.2% in 2005 (Posner, CongressDaily, 4/19).
Article link: http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=44358
Senator Tom Coburn
Subcommittee on Federal Financial Management, Government Information, and International Security
340 Dirksen Senate Office Building Washington, DC 20510
Phone: 202-224-2254 Fax: 202-228-3796
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