clock menu more-arrow no yes

Filed under:

MEDICARE BEING BILKED BY THE BILLION

Opponents of plans to reduce the growth of Medicare should be aware that this gigantic taxpayer-supported program is being bilked annually of at least 10 percent of its cost.

And even more startling is the fact this figure hasn't moved in 20 years. What is different, of course, is the amount of money this represents. In 1975 it was $3 billion. Today it's $17 billion, according to a new report delivered to Congress by a panel of government experts. Some believe it is as high as $20 billion.How discouraging.

Two decades ago, on the 10th anniversary of the adoption of Medicare, a Scripps Howard colleague and I wrote 60 stories documenting every kind of conceivable fraud being perpetrated on this and Medicaid, its sister for the poor.

The list included double billings, gang visits, Medicaid mills, laboratory scams, ping-ponging (sending a patient from one doctor to the next in a clinic and billing for them all) and prescription fraud, among the most common.

As is often the case, there was a flurry of government and medical profession activity to reform the system.

U.S. attorneys all over the country were on the alert to wipe out this rape of the system.

What was the result? June Brown, inspector general of the Department of Health and Human Services, now tells the Senate that "fraud and abuse permeate all aspects of the Medicare program."

Total expenditures for Medicare are expected to reach $177 billion this year, up from $107 billion in 1990. She said that as much as $17 billion will be wasted on fraudulent claims and that her office's enforcement actions have tripled since 1987.

She singled out home-health agencies, nursing homes and medical equipment suppliers as areas of special concern.

Two-time Pulitzer Prize winner Andrew Schneider and a Scripps Howard colleague, Lisa Hoffman, disclosed enormous fraud in home infusion and other home services during a yearlong study in 1993 that won several journalistic prizes but apparently failed to convince the government to take the steps necessary to stop it.

Now pay attention to this: It is estimated that fraud losses will amount to $138 billion between now and 2002 - about half the $270 billion that Congress has said must be squeezed out of the big program to eliminate the deficit over the same period.

Figure what the cost will be 20 years from now, if there is a Medi-care.