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Spending more on fraud and abuse than on Afghanistan

If we know this to be true, that is that the government pays $100 billion in improper payments a year, then here are the follow up questions:

Medical bill fraud and abuse
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  1. What is being done to take it back?
  2. What is being done to prevent it?
  3. Who are the abusers?
  4. Who are being prosecuted?
  5. For how long has this been happening?

The Fox News story actually answers some of these questions.

First the magnitude of the immediate problem is $100 billion a year for each of the past five years that is $500 billion. We don’t know if this is a recent anomaly or a system problem. It is probably systemic.

According to Fox News, Beth Cobert, deputy director of the White House budget office says they recovered $22 billion in overpayments last year. That is about 20%. Is that an acceptable amount and rate of recovery? No it is not.

Medicare and Medicaid are sources for waste, fraud and abuse. These programs are not the cause of the problem. The causes are from fraudulent medical corporations and doctors. Another aspect of the problem has to do with how medical claims are managed and checked.

Government should be performing in an automated regulatory environment. Checking should be automated, and to some extent it is. Are we allocating sufficient resources to medical and disability claims cost management? That is an important question.

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“'Staggering': Government making $100B in improper payments every year
Published July 09, 2014

The U.S. government is making roughly $100 billion in improper payments every year thanks to a combination of fraud, clerical errors and insufficient IRS enforcement, according to testimony at a congressional hearing on Wednesday.

“The amounts here are absolutely staggering,” Rep. John Mica, R-Fla., said.

The problem of erroneous payments – largely from Medicare and other health care programs – is not a new one. But Mica said at the hearing of a House oversight subcommittee that federal agencies reported over $100 billion in improper payments during each of the last five years.
That’s roughly what the Obama administration spent on the Afghanistan war and other security operations last year.

“That’s an incredible amount of money that has been misappropriated, mis-paid,” Mica said.
The money is coming from an array of agencies, and includes tax credits to families that didn't qualify, unemployment benefits to people who had jobs and medical payments for treatments that might not have been necessary.”

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