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Medicare Fraud Raises ‘Troubling Questions About Our Government’s Ability to Manage a Medical Bureaucracy’
- Text size
Noel Sheppard
NewsBusters
October 26, 2009
“60 Minutes” did a fabulous exposé Sunday on Medicare fraud that should be required viewing for all people who support a government run healthcare program in this country.
The facts and figures presented by CBS’s Steve Kroft were disturbing as were the details concerning how shysters bilk the system for an estimated $60 billion a year.
As Kroft warned viewers in the segment’s teaser, “We caution you that this story may raise your blood pressure, along with some troubling questions about our government’s ability to manage a medical bureaucracy” (video embedded below the fold with partial transcript, h/t Marc Sheppard):
STEVE KROFT, CBS: Of all the problems facing the United States right now, none are more important than healthcare. President Obama says rising costs are driving huge federal budget deficits that imperil our future, and that there is enough waste and fraud in the system to pay for health care reform if it was eliminated.
At the center of both issues is Medicare, the government insurance program that provides health care to 46 million elderly and disabled Americans. But it also provides a rich and steady income stream for criminals who are constantly finding new ways to steal a sizable chunk of the half a trillion dollars that are paid out each year in Medicare benefits.
In fact, Medicare fraud – estimated now to total about $60 billion a year – has become one of, if not the most profitable crimes in America.
We caution you that this story may raise your blood pressure, along with some troubling questions about our government’s ability to manage a medical bureaucracy.
Kroft spoke with FBI special agent Brian Waterman and Kirk Ogrosky, a top justice department prosecutor:
BRIAN WATERMAN, FBI: There’s a healthcare fraud industry where people do nothing but recruit patients, get patient lists, find doctors, look on the Internet, find different scams. There are entire groups and entire organizations of people that are dedicated to nothing but committing fraud, finding a better way to steal from Medicare
KROFT: Is the Medicare fraud business bigger than the drug business in Miami now?
KIRK OGROSKY, JUSTICE DEPARTMENT: I think it’s way bigger.
KROFT: What changed?
OGROSKY: The criminals changed…
WATERMAN: Sophistication.
OGROSKY: They’ve figured out that rather than stealing $100,000 or $200,000, they can steal $100 million. We have seen cases in the last six, eight months that involve a couple of guys that if they weren’t stealing from Medicare might be stealing your car.
WATERMAN: You know, we were the king of the drugs in the ’80s. We’re king of healthcare fraud in the ’90s and the 2000’s.
Kroft also spoke to Attorney General Eric Holder:
ERIC HOLDER, ATTORNEY GENERAL: We have to understand this is a major fraud area. [...]
KROFT: Why do you think it’s been so attractive for the criminals?
HOLDER: Because I think it’s been pretty easy. I think that they have found a way in which they have been able to get pretty substantial amounts of money with not a huge amount of effort and at least until now, without the possibility of great detection.
KROFT: With much fewer risks.
HOLDER: Much fewer risks. You’ll see some of these people and they’ll say “You know there is not a chance that you are going to have some other drug dealer shooting at you.” The chances of being incarcerated were lower, the amount of time that you would spend in jail was smaller. All of which is different now.
Kroft then spoke to a man who claimed to have defrauded Medicare out of $20 million, after which Kroft said, “According to the FBI, all you have to do to get into this business is rent a cheap storefront office, find or create a front man to get an occupational license, bribe a doctor or forge a prescription pad, and obtain the names and ID numbers of legitimate Medicare patients you can bill the phony charges to.”
WATERMAN: There’s a whole industry of people out there that do nothing but provide patients.
Kroft narrated, “Once the crooked companies get hold of the patient lists, usually stolen from doctors’ offices or hospitals, they begin running up all sorts of outlandish charges and submit them to Medicare for payment, knowing full well that the agency is required by law to pay the claims within 15 to 30 days, and that it has only enough auditors to check a tiny fraction of the charges to see if they are legitimate.”
Later, Kroft asked Waterman, “There’s something I don’t understand. I mean, you’re saying essentially people just fill out the phony paperwork, they send a bill to Medicare and they pay it.”
WATERMAN: That’s why you have companies that can run for 60, 90 days, and bill for ridiculous things. Because there are very few checks and balances to even determine whether these things a, were medically necessary, b, were ever given, or c, even physically possible for a patient with the kind of conditions they have.
A bit later in the segment, Kroft spoke with Kim Brandt, Medicare’s director of program integrity. After he shared with her some of the scams he’d previously witnessed or been told about, he asked how crooks get away with it:
KIM BRANDT, MEDICARE DIRECTOR: We’re as frustrated by that as the law enforcement officials that you went out with. And in fact, our primary focus over the past years has been to tighten our enrollment standards to make it so it’s much harder for people like that to be able to get in the program, and to be able to commit that kind of fraud.
KROFT: Look, I’m sure that you’re aware of these problems. But it doesn’t seem like you’re doing a very good job. I don’t mean you personally, but I mean, the government. This is still like a huge problem, and getting worse, right?
BRANDT: Well, it really does come down to the size and scope of the Medicare program, and the resources that are dedicated to oversight and anti-fraud work. One of our biggest challenges has been that we have a program that pays out over a billion claims a year, over $430 billion, and our oversight budget has been extremely limited.
Just imagine what the fraud will be like if the government is responsible for everyone’s healthcare.
As the segment drew to a close, Holder told Kroft something that should scare the heck out of everyone who wants government run insurance for all Americans: “I think people I don’t think necessarily thought that something as well intentioned as Medicare and Medicaid would necessarily attract fraudsters. But I think we have to understand that it certainly has.”
Yes we do.
Yet, shortly after this marvelous segment came to a close, “60 Minutes” concluded this installment with Andy Rooney telling viewers:
I’m not much interested in hearing anymore talk about health care.
President Obama wants to overhaul what they call the “health care industry.” Well good, but I hate that phrase the “heath care Industry.” I just don’t like to think of my health as an industry.
The fact is though being sick is often the least of our health problem. Even if you’re insured, what hospitals charge now is ridiculous. I had what they call “an outpatient procedure” recently and it cost my insurance company $9,361. I say it cost my insurance company but let’s face it. In the end, I’m the one who pays.
The U.S. spends more than any other country on Earth on its health: $2.5 trillion. And what do we get for $2.5 trillion? Well, we’re 50th in the world for life expectancy, below the Polynesian French Island Territory of Wallis and Futuna, wherever Wallis and Futuna are.
As Steve Kroft said earlier on 60 Minutes, we are losing billions of dollars on health care fraud. Not on healthcare – on healthcare fraud.
Everyone cheats – companies, hospitals, patients, doctors, drug companies, and government agencies. Cheating goes on everywhere in the get well business.
During my recent outpatient procedure a doctor came into my room, asked how I was doing and said, “By the way I love your work on television.” He left without touching me and a couple of weeks later when the bill came, it turned out his visit cost my insurance company $250.00.
I mean who knows what he would have charged if he didn’t like my work.
There’s just no doubt we need healthcare reform because the way it is now, makes me sick.
Makes you wonder if he even watched Kroft’s segment, doesn’t it?
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October 26th, 2009 at 1:17 pm
SEVERE penalties are in order for Medicare/healthcare fraud. Instead they mess with patriots! The gov can’t run a VA hospital effectively. Do you think they can run ALL American health care efficiently? Cuban health care may start to look GOOD! NOT!
FallOfTheRepublic Reply:
October 26th, 2009 at 2:51 pm
Fall of the Republic HQ full length version
http://spywitnessnews.org/cont.....rsion-2009
THE WATCHER Reply:
October 26th, 2009 at 4:52 pm
WOW, looks like a great business opportunity!
THE WATCHER Reply:
October 26th, 2009 at 11:32 pm
Hilarious article! – http://www.kfvs12.com/Global/story.asp?S=11177085
poopkeeper Reply:
October 27th, 2009 at 11:32 am
looks like the fed has shot themself in the wallet with this one, the medicare info fraud keeps the fbi going, also heard this morning on npr that the fbi is so backlogged on their “legal” wiretapping interpretation it will be years after any threat could come to fruition before the interpretation occurs, btw where are wallis and futuna?
Unconquered Reply:
October 26th, 2009 at 3:42 pm
Amen Mac. If you look at the VA system and how horribly they treat soldiers who sacrifice so much for the country, think about how bad they’ll treat you and me! People say Medicare is so great but amid the fraud, its going to be insolvent like social security. Great if you’re higher up the Ponzi pyramid but for the rest of the younger, healthier population. Too bad, so sad.
Dante Reply:
October 26th, 2009 at 3:59 pm
this is REAL …BUT THIS ARTICLE IS BULLSHIT …THIS IS AN ATTEMPT TO CUT MEDICARE FOR SENIOR CITIZENS …DUHHHH!!!! PROBLEM REACTION SOLUTION….FRAUD IS EXPENSIVE SO WE SHOULD….KILL OLD PEOPLE …BY GETTING RID OF MEDICARE….MEANWHILE THE FBI SAYS ITS NO LONGER GOING TO INVESTIGATE WHITE COLLAR CRIME …..THESE VIDEOS ARE PROPAGANDA FOR THE ILL INFORMED …PLEASE DON’T BELIEVE FUCKIN CBS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Dante Reply:
October 26th, 2009 at 4:02 pm
MEDICARE IS THE LAST VESTIGE OF NEW DEAL PROGRAMS THAT KEEP THE STANDARD OF LIVING IN THIS COUNTRY FROM REACHING THAT OF THE THIRD WORLD ….DO NOT BELIEVE THIS PROPAGANDA!!!!
Dante Reply:
October 26th, 2009 at 4:03 pm
COME ON ANDY ROONEY SAID HE WOULD TAKE THE MICROCHIP http://www.youtube.com/watch?v=WDW4CAAbvA4
BattleHardened Reply:
October 26th, 2009 at 8:54 pm
look how screwed military health care is to, they tell you full benefits then they tell you the Army’s not willing to pay for it, if you want to know how government health care is run picture this, someone upstairs is told to cut cost how is he going to do this, and what about priorities when has the government ever made saving life a priority, and what about employment and government waist, has anyone ever seen the government ever honor their word in their own lifetime ex borders social security, Medicare, unemployment, lower taxes ec
October 26th, 2009 at 1:28 pm
Remember, not all of these elites want all of this stuff going through. They actually care about their families and care about their families.. It’ll all fail. I am not as worried as I was 6 months ago.
Carla Reply:
October 26th, 2009 at 2:00 pm
Ismhr
If you’re not as worried as you were six months ago, you’re either taking some Serious medication, or you’re not paying attention !
SPIRITBLADE Reply:
October 26th, 2009 at 2:21 pm
BAMM!
October 26th, 2009 at 1:43 pm
60 minutes? Is that a bit like the British Panorama program?
October 26th, 2009 at 1:45 pm
Yeah Andy Rooney and you make me sick…thank God i have a strong immune sysyem to shills and liars and dictators. Peace out!
October 26th, 2009 at 1:56 pm
Republican and Democrat Health Care = F U B A R !
October 26th, 2009 at 2:02 pm
I don’t think Andy ‘Looney’ Rooney watched Kroft’s segment at all. What in the hell costs $9,361 for an out-patient procedure? Was ‘Looney’ having lyposuction done on that thing hanging from his upper lip? Also, Mr. ‘Looney’, get rid of the teleprompter. You look like Marty Feldman when you are reading it.
Zeebob Reply:
October 26th, 2009 at 3:52 pm
I didn’t see the show but 2 years ago my wife had a kidney stone treated with ultra sound as an out patient. We were there for three and a half hrs. The procedure itself was 45 min. The doctor fee was $1,500.00 The total bill was over $8,000.00. Thats over $6,500.00 for the hospital.
wewton Reply:
October 26th, 2009 at 6:44 pm
I reason that, 500 bucks would be a fair price for that. imo.
October 26th, 2009 at 2:09 pm
Medicare knows what is going on. Anytime you have all that money changing hands you know there is fraud. The head personnel at medicare are running fraud scams from the inside. They have been for a long time. The only thing that has changed is that some outsiders caught onto the scam and are running their own scams now, and the insiders are allowing it to happen for fear of upsetting the apple cart. They don’t want to jeopardize their own scams.
As America collapses, more and more wolves will nibble at the edges.
October 26th, 2009 at 2:16 pm
7deviations said
“As America collapses, more and more wolves will nibble at the edges.”
I like how you put that.
October 26th, 2009 at 2:18 pm
IF YOU ARE ON MEDICAID, NOW HEAR THIS:
YOU will be AUTOMATICALLY TRANSFERRED to the new “HELLTH-CARE” plan, WHEN it goes into effect.
COME-OUT OF EGYPT.
[ARM-UP, SPREAD - OUT]
SPIRITBLADE Reply:
October 26th, 2009 at 2:21 pm
In the event you missed the reality of the new “Hellth-care” system, it is the seed for the mark of the beast.
October 26th, 2009 at 2:25 pm
WOW, IF I WAS THAT GUY I WOULD CASH IN ONCE AND FOR ALL ON THAT 20 million AND BUY GOLD AND QUIT. I don’t care about the govt, let them go bankrupt so they could get the hell out of healthcare
I GUESS ONCE YOU START EARNING EASY MONEY, YOU JUST CAN’T STOP
October 26th, 2009 at 2:26 pm
It would be handled the same way as getting an adequate supply of the H1N1 vaccine ready for something they new was coming. Pure incompetence, I’d be surprised if these buffoons tie there own shoes.
October 26th, 2009 at 2:32 pm
And obamacare would be better??? Hahahahahahahahaha
October 26th, 2009 at 2:36 pm
Normally, I HATE 60 Minutes, but in this case, I’d recommend that you have everyone you know watch it.
Art Reply:
October 26th, 2009 at 11:54 pm
I just watched it,guess what,crazy make up,good actor.They want to believe us that the money they still from us is nothing compared with some guy from some village.Sure they still also,but the amounts?…Come on man…
October 26th, 2009 at 3:20 pm
Hey guys, i’m really not trying to sound paranoid here but I figured with obama declaring a national emergency it might be wise to check and see if he issued any executive orders to go along with it.I figured I might get a little bit of a heads up as to exactly what his plans are. On whitehouse.gov when you search for obamas executive orders it comes up 404 page not found.Can you guys check that out and see if you get the same result? I find it more than a little creepy that at this pertinent time we cant see his executive orders
October 26th, 2009 at 3:59 pm
PRINCESS, is that you? I hope it is and you’ve finally come to your senses.
Married to 1/3 Native American Reply:
October 27th, 2009 at 10:37 am
Her premiums must be going up!
October 26th, 2009 at 4:30 pm
October 9 2009 at 10:04 -10:32 I spotted a strange cloud formation (a circular cloud )
I proceeded to take over 50 pictures and decided to make a small video on what I had seen ! I had noticed while making the video that there was another strange cloud seen above moscow on the same day !
http://www.youtube.com/watch?v=ZjuI_5N9sqQ
October 26th, 2009 at 4:39 pm
Even an out of touch 100 year old fossil like Rooney knows the score. He must have had his Mexican gardener trim those “Sesame Street” eyebrows. Good work Andy, you old fart.
October 26th, 2009 at 4:53 pm
############### SPREAD THIS INFORMATION ###############
Wall Street criminals exposed By Marcy K.:
kaptur.house.gov/index.php?option=com_content&task=view&id=289&Itemid=1
youtube.com/watch?v=tMCZ8JeEpUw
or
fednet.net/asx/2008/kaptur092208.asx
Tim Geithner refusus to answser Brad Shermans question:
youtube.com/watch?v=rEpmRv2kAng
or
youtube.com/watch?v=_nWFfJQtoT8
HQ version: youtube.com/watch?v=Gvt1uzLv15o
Rep. Alan Grayson asks the FEDERAL RESERVE Inspector General where the money is gone..:
youtube.com/watch?v=PXlxBeAvsB8
HQ version: youtube.com/watch?v=cJqM2tFOxLQ
**********END THE CRIMINAL RESERVE – ACTION STEPS**********
Bills to be supported: S 604 and HR 1207
ronpaul.com/on-the-issues/audit-the-federal-reserve-hr-1207
or
http://www.campaignforliberty......d-home.php
or
auditthefed.com
Stop and jail Ben criminal Bernanke:
www(dot)unmaskthefed.com
############### SPREAD THIS INFORMATION ###############
October 26th, 2009 at 5:03 pm
########### STOP OBAMA’S HEALTHCARE BILL HR-3200 ###########
Sign the petition:
(Copies will be sent to your Senators and Representative in Congress)
http://www.campaignforliberty......thcare.php
########### STOP OBAMA’S HEALTHCARE BILL “HR-3200 ###########
October 26th, 2009 at 5:14 pm
Not every half what the banks got.
October 26th, 2009 at 5:15 pm
Not even half what the banks got
October 26th, 2009 at 6:27 pm
Watch for free:
Fall Of The Republic, Obama Deception, Endgame, Terror Storm, Loose Change, Aaron Russo’s Famous Interview (Must See), Citizen Investigation Team, Fabled Enemies, 911 Blueprint For Truth, and others all in full-length at my website.
http://www.joemarquis.com/videos.htm
I still encourage each and everyone to purchase the DVD’s to help keep the fight going.
October 26th, 2009 at 6:39 pm
Alex’s new DVD “Fall of the Republic” shows the corruption in our government so clearly it will really wake some people up.
I handed out about 120 copies Obama Deception and I plan to do the same
for this one.
We all need to pass out copies all over our own towns because if the
people around us are not awake, we’ll be in big trouble when it all comes
crashing down.
I put up a website with the simple step-by-step method I use to make
copies that play on even the cheapest DVD player and TV.
Check it out and see how easy it is to copy Alex’s movies:
http://www.thetinyspark.com
-Dusty
October 26th, 2009 at 6:42 pm
1,200,000,000 … yes ! 3000 fake stores that profit 400k each = 1.2 billion dollars, and thats just in one city alone.
If all three thousand fake stores start a new store every 3 months (per 3 month cycle to avoid detection), that means you could multiply that amount times 4 annually (per store), which could equal 4.8 BILLION PER YEAR in fraud per city.
Multiply that times (only) 20 major US cities, and you have annual USA medical fraud somewhere in the neighborhood of 96…. Yes thats 96 billion dollars in fraud every year potentially.
Add just one more city mathematically & you have a 100 BILLION DOLLAR PROBLEM !!!
YIKES!
And you wonder why it costs so much for basic health services???
So in reality the real amount of drugs, supplies and diagnosed conditions must be WAY WAY off statistically from all reported statistical measurements.
October 26th, 2009 at 6:55 pm
When ” money ” is the main driving force , you can’t expect much , but when the ” leaders ” are
thoroughly corrupt on top , giving the bad example , you can forget it !!!
P.S. Study herbs and the Ayurveda , and stay away from the medical establishment as much as
possible !!!
October 27th, 2009 at 12:38 am
If they went after healthcare fraud they could fill all the fema camps up, but then they would have to provide those people health care
October 27th, 2009 at 12:50 am
MESSAGE FOR INFOWARRIORS ON EU LISBON TREATY STATUS
We wish to inform you that a Website has been set up to provide information on the current status of affairs concerning the irregularities that surround the Referendums concerning 28th Amendment to the Irish Constitution and on details on how these matters are progressing through the courts.
The Website can be viewed here http://irishcitizens.blogspot.com
In brief:
The website outlines details of five cases brought on 12 October 2009 by Four Concerned Citizens of the Republic of Ireland which challenge, by way of Judicial Review, the validity of the 28th Amendment to the Constitution Bill (2009). The Attorney General had indicated that Ireland was not in a position to ratify the Lisbon Treaty unless there was a successful referendum and an amendment to Bunreacht na hÉireann – the Irish Constitution.
The cases are:
1. REA -V- IRELAND & ORS 2009/1042 JR;
2. MC CRYSTAL -V- IRELAND & ORS 2009/1043 JR;
3. BEHAL -V- IRELAND & ORS 2009/1044 JR;
4. BENNIS -V- IRELAND & ORS 2009/1045 JR.
These cases, all of which were refused ex-parte leave for Judicial Review are now formally appealed to the Supreme Court and this process of appeal is ongoing. Priority listing will be applied for but it is unlikely that the appeal will be heard within the next two weeks and likely even longer.
Yours sincerely,
Concerned Citizens
October 27th, 2009 at 3:37 am
What 60 minutes failed to emphasize is that it is not the beneficiaries of Medicare that are defrauding the system, it is criminals and corrupt corporations. Furthermore, the same sort of fraud is perpretrated on private health insurers and the effects are the same – higher costs. This is not a valid argument against government-run health care, it is an argument against doing more to stop fraud.
Unconquered Reply:
October 27th, 2009 at 12:46 pm
Because it IS a government-run program is EXACTLY why your government doesn’t give a shit about this. The money comes out of YOUR, MINE, OUR pockets. They don’t pay for it, so they don’t have any fiduciary responsibility to protect YOUR money. They have THREE agents in Florida? Really? Maybe if they stopped wasting their expenses they could hire more people. I guarantee you a private business owner could deploy the resources that Medicare has in a much more efficient, cost saving, responsible manner than your government. I also guarantee that a private health insurer is EXPONENTIALLY better at tracking stolen money from fraud because its their bottom line. Government doesn’t have to worry about its bottom line. It just taxes us more, puts out more cheap money and spend spend spend.
October 27th, 2009 at 3:44 am
The only problem is they don’t have enough oversight and armed goons to go after these greedy slime balls. Now it makes a whole lot of sense when people attack medicare or health care in general. There’s too much waste and that’s where all the money is going. Take some of the lazy fascists thugs in the DEA and the FBI from behind their desk chasing non-violent drug offenders and catch these thieves so we all can have free health care without waste and abuse. Take some of the police with their tear gas and tazers chasing law abiding protesters and get them on the job too. If someone is committing fraud then bust them. It’s just white collar crime. Throw them in jail. The government does a great job all the time in killing in Iraq and Afghanistan and in street protests. Get them to bust some heads of rich white collar crime.
October 27th, 2009 at 9:57 am
i agree something need to be done about this . my thought or question is this the new world order eating the new world order?
October 27th, 2009 at 11:18 am
Just been readin the comments. 80-90% of you are morons who cant uphold a conversation or speak on topic. Cult followers.
Greg. Spot on my man.