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A Times Editorial

Keep after the Medicare fraudsters

In what U.S. Attorney General Eric Holder described as "the largest federal Medicare fraud take-down in history," hundreds of federal agents swept five cities, including Miami, earlier this month to arrest 94 people accused of stealing $251 million from taxpayers by submitting bogus Medicare reimbursement claims. The Obama administration's unrelenting pursuit of Medicare fraud is what it will take to stop this wholesale abuse of the Medicare system.

The government's goal "is to hammer people," Holder said bluntly, "so if you steal from the American people … you will go to jail. That is the message."

Doctors, medical assistants and clinic owners were among those arrested in Miami, New York, Houston, Detroit and Baton Rouge, La. But also involved in the racket were qualified Medicare recipients who let the schemers use their Medicare patient numbers on the fictional claims in exchange for cash, new televisions or other valuables. These "patients" neither needed nor received the wheelchairs, prescriptions, physical therapy and other medical supplies and treatments on the false bills submitted to Medicare, but Medicare paid the bills and criminals were enriched.

Since the federal government launched its Medicare fraud strike force in Miami in 2007, 810 individuals and organizations have been charged with billing Medicare for $1.85 billion in false claims. "But we are just getting started," said Health and Human Services Secretary Kathleen Sebelius at a news conference. Changes in federal law have given the government new powers to monitor Medicare reimbursement claims in real time, spot suspicious claims before they are paid and investigate whether there is an actual medical provider behind the bills or just locked offices. A locked office is all Sebelius found in Miami when she toured a building where Medicare claims had originated.

Fraud on such a massive scale has driven up the cost of health care in the United States and affected the solvency of Medicare. The Obama administration needs to keep turning up the pressure and make examples of those who perpetrate these frauds that affect all taxpayers.

Keep after the Medicare fraudsters 07/27/10 [Last modified: Wednesday, July 28, 2010 6:28pm]
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