Wednesday, October 13, 2010

Medicare Fraud - Scam Artists' Way of Making a Living

In the United States, Medicare fraud is a general term that refers to an individual or corporation that seeks to collect Medicare health care reimbursement under false pretenses. - From Wikipedia
This has cost the American taxpayers at least billions of dollars each year, lost into someone else's pocket.
If you're wondering how this happen, do read this:

(1) Phantom Billing: The medical provider bills Medicare for unnecessary procedures, or procedures that are never performed; for unnecessary medical tests or tests never performed; for unnecessary equipment; or equipment that is billed as new but is, in fact, used. In which case, every form of billing, phantom or patient, can be prevented through carefully checking.
(2) Patient Billing: A patient who is in on the scam provides his or her Medicare number in exchange for kickbacks. The provider bills Medicare for any reason and the patient is told to admit that he or she indeed received the medical treatment.
(3) Upcoding scheme and unbundling: Inflating bills by using a billing code that indicates the patient needs expensive procedures.


All of these things happen easily because originally the Medicare system was set up for honest Doctors to efficiently treat their patients but among the good ones are always a dead fish. The scam artists would do whatever it takes to grab the extra money into their own pocket. Recently in July, some of these scam artists were arrested as shown in New York Time's news. According to the news there were 8 people doing the scam and tried to earn at least $72 million. This $72 million could have been efficiently used to help the sick to survive another day.
We all should say no and give no support to all these fraudulent actions.
What do you think?

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