Medicare’s Most Wanted

Medicare is under intense scrutiny because of its $519 billion annual budget, which is estimated to balloon to nearly a trillion dollars in 2020 as the boomers age into the program. That kind of money sloshing around the system has made Medicare fraud one of the nation’s top white-collar crimes. Fraudulent billing may have siphoned off nearly 40 percent of those billions.

See also: The Patient Protection and Affordable Care Act.

The Affordable Care Act attempts to address that problem with better and faster access to records, more funding for investigations and targeted strike forces, and by excluding those corporations that abuse the system. For three years, Inside E Street has been tracking federal efforts to combat Medicare fraud.

Lark McCarthy discusses progress on fighting Medicare fraud with Dr. Peter Budetti, Director of Program Integrity for the Centers for Medicare & Medicaid Services (CMS), and with Greg Andres, Deputy Assistant Attorney General. Jay Weaver, an investigative reporter with the Miami Herald, updates us on the latest convictions in the mental health fraud in Miami/Dade County, Florida.

The background report contains exclusive footage of a recent HHS Office of Inspector General bust in Miami and an interview with Deputy Inspector General Gerald Roy about some of the tools available following health care reform.