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Medicare fraud and incompetence results in overpayments to the dead

According to a recent CNN report “the Centers for Medicare and Medicaid Services doled out $23 million in benefits to 17,403 deceased beneficiaries in 2011. The audit was done by cross-referencing Medicare recipients with Social Security death records from 2009 to 2011.” This about Medicare fraud is not welcome, especially given its role in helping administer the Obamacare website.



The news is on the heels of another recent announcement by the Social Security Administration that they too overpaid an estimated $1.3 million in over payments in just the last two years. According to CNN, “as of May 2012, approximately 1,546 deceased beneficiaries had received Social Security benefits for months or even years after their deaths -- totaling $31 million in improper payments, according to the most recent audit.”

Admittedly, some of the over payments are made to individuals who are intentionally committing fraud within the system, but a large number are actually made to innocent claimants who did not realize that they were receiving overpayment.

How is the Medicare fraud committed?


Just like all government waste and fraud, the reasons for Medicare fraud is both sinister and innocent. Throw in a little extra government incompetence and most of the problems can be explained.

For example, those intentionally committing Medicare fraud are those who request Medicare benefits when they are not eligible. Others assume the identities of those who have died. Still others simply fail to notify the Medicare that the beneficiary is deceased, and the agency may not know to terminate benefits. Another cause for concern is the proliferation of fraud by illegal aliens who are not in the USA legally. According to the study, an estimated $29 million in Medicare benefits were given to individuals who were not authorized for benefits due to their alien status.

The good news is most of the fraudulent Medicare payments, an estimated 58%, were for payments which were less than $1,000. A dozen or so were for more than $50,000 and two recipients, according to CNN, received payments for more than $100,000 each.

The agency is also quick to note that they pay out an estimated $500 billion each year and $23 million in payments is a very small percentage of that amount.

What does the government say about Medicare fraud?


The government has agreed to implement some of the recommendations provided from the study to combat Medicare fraud. For instance, they do intend to analyze methods to improve their systems, to provide better information to health care providers with a claimant’s date of death to eliminate payout for claims which are after the date of death, and implement plans to recover improper payments.

Medicare fraud and other types of waste should frustrate all of us. The government does not generate money; it’s money which is earned by each of us, taken from us, and distributed illegally to those who do not qualify for benefits. This waste also does not include the possible fraud that might be perpetuated as millions of Americans move their healthcare management to exchanges and into Obamacare.
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