U.S.
Sep. 24—By Vicki Hyatt
Here's is the perfect action plan for anyone who decries wasteful government spending and thinks the problem is beyond their control.
Consider this: Medicare paid $829 billion in claims in 2021, and of that amount, $60 billion was estimated to have been fraudulent charges.
The way the program is set up, medical providers directly bill Medicare for services they render to the 67 million people on government insurance program. Unless the bills are challenged, or a company has been flagged as suspicious, there is no easy way to determine which bills are legitimate and which bills are not.
Rather than wait for "government" to solve the problem, here's an idea. Every one of those who receive Medicare are the first line of defense against fraud.
Medicare provides quarterly summaries to all on the program listing the bills paid on their behalf. That means there are 67 million pairs of eyes that could potentially review the bill and report suspicious payments.
It is the best possible solution to successfully attacking fraud and to keeping a program that is loved by every senior citizen I know solvent.
I know from personal experience how easy the process is.
One bad thing about getting older is the opportunity to periodically check out the medical resources in the community.
In the past year, I've found three situations to report, all slightly different, but all resulting in our taxpayer dollars being paid out wrongfully. One was an honest mistake when my husband was billed for a medical visit that should have been billed to someone with the same name but a different birth date.
The second was for Covid tests received, but never ordered, and most recently, I noticed was for durable medical equipment called a "cath unit," something I'm quite sure I'd remember needing or using.
The bill was for nearly $4,000 and was paid by Medicare for charges billed in both June and July by a company I had never heard of. A small consolation was that Medicare had dropped the amount paid to slightly under $3,000 for the charges.
I immediately called the Medicare number and selected the option to report fraud where I ended up speaking with two different individuals. Within 25 minutes, the wrongful claim had been reported, and I was assured the matter would be handled through an investigation and Medicare recovering payments made wrongfully.
A woman named Geraldine said she noted I had made several other Medicare fraud claims, and suggested I could get a new number since my present one was apparently being used by companies looking for a quick way to cheat the system.