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Scams & Fraud
AARP Florida, August 12, 2010
Recent headlines in South Florida newspapers heralded major arrests in a nationwide scam ring aimed at ripping off millions of dollars from Medicare. Hispanic families in South Florida may have shrugged at the news and wondered what it had to do with them.
Actually, health-care ripoffs are one important reason why health-care costs are so high and getting higher. Americans pay twice as much for health care per capita, on average, as people living in other developed countries. Sadly, law-enforcement authorities estimate that fraud, waste and abuse cost U.S. taxpayers as much as $60 billion across all public health-care programs. Together, the United States spent more than $1 trillion on all public health programs in 2004, roughly half of all health spending.
This is why last month, AARP endorsed bipartisan legislation to prevent Medicare fraud. These endorsements build on strong measures enacted under the health care law to combat fraud in Medicare and throughout the health care system.
“Our members and all older Americans deserve to know that their premiums and tax dollars are protected from fraud,” said AARP Executive Vice President Nancy LeaMond. “Medicare fraud costs billions of dollars each year, but can be prevented for a fraction of the cost.”
The Medicare Fraud Enforcement and Prevention Act (H.R. 5044), sponsored by Reps. Ron Klein (D-FL) and Ileana Ros-Lehtinen (R-FL), and companion Senate legislation (S. 3632), sponsored by Sen. Kirsten Gillibrand (D-NY)would strengthen the penalties for Medicare fraud and make it illegal to distribute Medicare identification numbers with the intent to defraud the program. The bills would also give law enforcement officials quicker access to Medicare claims data, allowing them to act swiftly when suspicious activity is spotted.
“The best way to save seniors and taxpayers money while keeping Medicare strong is to get tough on criminals and stop crimes before they start—and that is why our bill does both,” Rep. Klein said. “This innovative, bipartisan solution will help ensure that crooks can no longer open fake businesses or submit false paperwork to steal tens of billions of dollars a year from senior citizens and taxpayers.”
“Medicare fraud is a problem that hurts our most vulnerable citizens,” said Rep. Ros-Lehtinen. “An estimated $60 billion is stolen from Medicare annually and reform is sorely needed and must be achieved if we are going to restore the trust seniors have in our government services. South Florida is known as the epicenter of Medicare fraud and this is why Ron Klein and I are working together for a solution to this intolerable problem. Our ‘Medicare Fraud Enforcement and Prevention Act’ will provide badly needed reform to the Medicare system.”
H.R. 5546, sponsored by Rep. Peter Roskam (R-IL), would create a stronger process for Medicare to review claims before paying providers. This review would screen out likely fraudulent claims to ensure payments are made to legitimate providers.
AARP’s LeaMond added: “We applaud Sen. Gillibrand and Reps. Klein, Ros-Lehtinen and Roskam for coming forward with innovative ideas to stop fraud and punish those who commit it. These are important components in a more holistic effort to not only fight the fraud that is occurring, but also ensure fraud is stopped before it happens through strong preventive measures. AARP will pursue all necessary remedies to effectively fight fraud for which we all pay, and we urge Congress to make Medicare anti-fraud efforts a priority and pass these bills.”
AARP has called on Congress to make other needed changes to combat fraud, such as removing Social Security numbers from Medicare cards, performing additional screening of providers and suppliers, and analyzing Medicare claims data to find suspicious billing.
In the coming months, AARP will be ramping up additional efforts to combat Medicare fraud, both through advocacy for national policy changes and by engaging its members at the local level. AARP encourages anyone in Medicare to look carefully at their Medicare Summary Notice for any services or supplies they never received. Those who find suspicious activity should ask their providers about the charges, and then contact Medicare through its fraud hotline, 1-800-MEDICARE (800-633-4227), if they still have questions.
AARP has more information about stopping health care and Medicare fraud available on www.aarp.org.
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