Twisted Musings

The ineptitude in Washington is mind-boggling!!

    It was recently reported that Medicare was advised over three years ago
    that scammers were cheating Medicare and Medicaid out of billions of
    dollars each year, and Medicare’s response:  we didn’t have the funds
    available to address this problem.  How lame….no, how downright
    stupid……is that?

    It’s been estimated that scammers have cheated Medicare out of at
    least $60 Billion over the past three-year period.  And it’s so easy, and
    safe, that organized crime has diverted their drug-smuggling efforts
    to scamming Medicare……it’s much more lucrative, with less chance of
    being caught, and if caught, the penalties are less severe.

    One problem is that Medicare has a policy of paying claims within a
    15-to-30 day period.  This does not allow them enough time to verify
    that a claim is legitimate.  Eventually, they do try to verifty companies
    submitting claims, but by then, the scammers have ‘closed shop’ on one
    phony company and opened another one with a different name and
    location. 

    Some of the scammers attempt to appear legitimate…..they open a
    pharmacy or medical supply store, and while they do dispense some
    merchandise, the main focus is to submit a large number of phony
    claims using bought or stolen information of real people who are
    ‘clients.’  Other scammers simply submit claims – again with purchased
    or stolen ‘client’ information – and just enter a phony address.  Medicare
    payments are sent directly to the scammer’s bank accounts.

    One unlucky fellow – one of the few to get caught – said it was easy…..
    he said Medicare was depositing $40 – $50 thousand dollars per day
    into his business account.  He and a partner received $20 million before
    being caught.  He said their mistake was staying with the phony
    address too long.

    I don’t know about you, but I find this preposterous……I mean, my God,
    how hard can it be to verify that a business actually exists, and that it
    purchases supplies of the type and quantity that it says it dispenses?

    Perhaps I’m a skeptic.  But it seems to me this is one of those situations
    where there is so much money involved, and so much opportunity
    for corruption at all levels, that those in charge don’t really want to
    resolve the problem.

    But then, that’s just me.  And what do I know?