Cost of Medical Fraud Could Pay for Health Care Reform

Get your news from a source that’s not owned and controlled by oligarchs. Sign up for the free Mother Jones Daily.


According to reporting yesterday on NPR, the cost of medical fraud in the United States runs anywhere from $60 billion to $600 billion a year–in other words, it might actually exceed the price tag for health care reform. Instead of whining about the expense of reform measures, Republicans and Blue Dog Dems might think about saving us money by cracking down on fraudulent practices, which target both the government and private insurers. 

Obama has recently announced a new DOJ/HHS task force to combat fraud, and some versions of the health care reform bill have a measly $100 million set aside for anti-fraud measures. It seems like far too little and too late–but apparently, it’s more than has been done by past administrations, or by the oversight committees, the appropriations and legislative committees whose job it is to ride herd on taxpayer funds. 

Here is a bit from the NPR report:

Medical fraud takes several forms. Most commonly, criminals get a list of patients’ names, then create fictitious doctors. They send bills to Medicare or Medicaid or health insurers for services supposedly rendered to these patients. By the time the payers figure out that the doctors they’re paying are fictitious and no service was ever rendered, the criminals have closed up shop and moved on.

Another popular form of health care fraud is the “rent-a-patient” scheme. Recruiters find people with health insurance willing to get care they don’t need, in exchange for cash or cosmetic surgery. Several years ago, insurers and the FBI said they had cracked a big case. People from 47 states were paid to come to California to receive unneeded care, including colonoscopies and surgery for sweaty palms. The doctors who performed the work reportedly charged insurers a total of $1 billion.

I suppose the libertarian Republicans would say it’s just a small price to pay for our free market system. And of course, if the government started taking a closer look at the crooks who illegally rip off the system, they might also have to deal with the crooks who rip off the system quite legally–the price-gouging insurance and pharmaceutical companies and their ilk.

BEFORE YOU CLICK AWAY!

“Lying.” “Disgusting.” “Scum.” “Slime.” “Corrupt.” “Enemy of the people.” Donald Trump has always made clear what he thinks of journalists. And it’s plain now that his administration intends to do everything it can to stop journalists from reporting things they don’t like—which is most things that are true.

No one gets to tell Mother Jones what to publish or not publish, because no one owns our fiercely independent newsroom. But that also means we need to directly raise the resources it takes to keep our journalism alive. There’s only one way for that to happen, and it’s readers like you stepping up. Please help with a donation today if you can—even a few bucks will make a real difference. A monthly gift would be incredible.

payment methods

BEFORE YOU CLICK AWAY!

“Lying.” “Disgusting.” “Scum.” “Slime.” “Corrupt.” “Enemy of the people.” Donald Trump has always made clear what he thinks of journalists. And it’s plain now that his administration intends to do everything it can to stop journalists from reporting things they don’t like—which is most things that are true.

No one gets to tell Mother Jones what to publish or not publish, because no one owns our fiercely independent newsroom. But that also means we need to directly raise the resources it takes to keep our journalism alive. There’s only one way for that to happen, and it’s readers like you stepping up. Please help with a donation today if you can—even a few bucks will make a real difference. A monthly gift would be incredible.

payment methods

We Recommend

Latest

Sign up for our free newsletter

Subscribe to the Mother Jones Daily to have our top stories delivered directly to your inbox.

Get our award-winning magazine

Save big on a full year of investigations, ideas, and insights.

Subscribe

Support our journalism

Help Mother Jones' reporters dig deep with a tax-deductible donation.

Donate