Oh, good: Federal govt pushing to intensify fight against health-care fraud

posted at 2:41 pm on July 26, 2012 by Erika Johnsen

Never fear, good people — the federal government is on the job!

As we already know, the American taxpayer loses gobs of money to the waste, fraud, and abuse inherent in bureaucratic programs like Medicare and Medicaid, but don’t worry, guys — this time, the federal government is really going to get serious and crack down on all of the fraudulent activity, they mean it. And yet… why am I not reassured?

The Obama administration is upping the ante in the fight against health care fraud, joining forces with private insurers and state investigators on a scale not previously seen in an attempt to stanch tens of billions of dollars in losses.

Health and Human Services Secretary Kathleen Sebelius said in a statement Thursday that the new public-private partnership “puts criminals on notice that we will find them and stop them,” …

Details of the collaboration remain to be worked out, but the possibilities include sharing information on new fraud schemes as they pop up, using claims data to catch scams such as payments billed to different insurers on the same day for care purportedly delivered to the same patient in different cities, and using computer analysis to spot emerging patterns of fraud. …

Fraud is estimated to cost Medicare about $60 billion a year, and the Obama administration has beefed up the government’s efforts to stop it, bringing in record settlements with drug companies for marketing violations as well as using new powers in the health care law to pursue low-level fraudsters with greater zeal. …

Some antifraud efforts launched with great fanfare have yet to deliver convincing results. For example, a $77-million computer system unveiled last summer to stop Medicare fraud before it happens had prevented just one suspicious payment by Christmas.

Egads – I wonder how many new bureaucrats this endeavor is going to take? The federal government certainly does like to keep itself busy, what with all this relentless expansion and new powers and tasks they’ve been assigning themselves (which would also explain why public-sector workers are so much more productive than private-sector workers. …Ha. Just kidding.).

I generally find that throwing more bureaucrats at a problem tends to decrease the efficiency and effectiveness of solving said problem, while creating even more problems in the meantime. Think about it: If the federal government possesses the august wisdom as well as complete array of knowledge it takes to be able to prevent such problems, why were Medicaid and Medicare so disastrous in terms of waste, fraud, and abuse in the first place? Because bureaucrats cannot foresee all of the secondary effects of their ostensibly well-meaning intentions, but they can enforce bad policy through fiat. Just a friendly reminder of everything we have to look forward to while we “find out what’s in” the legislative juggernaut currently overhauling our health care system and imposing a whole host of new taxes, regulations, and entitlements, yippee!


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Nine most terrifying words in the English language. (h/t The Gipper)

Lost in Jersey on July 26, 2012 at 2:44 PM

Health and Human Services Secretary Kathleen Sebelius said in a statement Thursday that the new public-private partnership “puts criminals citizens who disagree with our Socialist takeover on notice that we will find them and stop them,”

FIFY, you abortion tramp.

OhEssYouCowboys on July 26, 2012 at 2:45 PM

a $77-million computer system unveiled last summer to stop Medicare fraud before it happens had prevented just one suspicious payment by Christmas.

Wow, so it only cost us $77 million to save a couple hundred bucks?

What a bargain.

AZCoyote on July 26, 2012 at 2:45 PM

And how many valid claims get denied by the new bloated anti-fraud bureacracy? I’m betting lots…

Marcola on July 26, 2012 at 2:46 PM

You cannot have a Utopia without a mindless, emotionless, useless bunch of tools – known as the bureaucracy.

Be patient, they’re here to help you, especially when you need them the most.

Forward to Utopia, Comrades!

OhEssYouCowboys on July 26, 2012 at 2:48 PM

Dealing with healthcare fraud should have been one of the first places to start with healthcare reform, at least with regard to reducing costs.

Hey, maybe it’s buried somewhere in the bill that no one read – the one Pelosi said we had to pass to find what was in it (it was a Christmas present!).

The next thing we’ll hear from President Pout is that he’s creating jobs, jobs, jobs.

What we won’t hear is how much this will cost.

Next…………………..

Cody1991 on July 26, 2012 at 2:50 PM

I thought this problem was solved the first ten times Washington said it would solve the problem.

Silly me!

Liam on July 26, 2012 at 2:50 PM

The proliferation of bureaucrats and its invariable accompaniment, much heavier tax levies on the productive part of the population, are the recognizable signs, not of a great, but, of a decaying society.

- William Henry Chamberlain

OhEssYouCowboys on July 26, 2012 at 2:52 PM

“Hello. I’m a federal bureaucrat and I’m here to sodomize help you.”

platypus on July 26, 2012 at 2:53 PM

Medicare is farmed out to a few processors that are pretty good and maintain very large databases.

But move the issue to Medicaid (usually a 50/50 partnership between the Feds and the state) where I understand the administration is left to the state. So essentially we have 50 separate small systems with very little incentive to minimize fraud since Uncle Sam is paying for at least 50%.

I’m sure someone will chime in and correct my understanding…but if I’m right, then I think this might be a case for federal oversight since we all have a stake in what happens in any other state.

teejk on July 26, 2012 at 2:53 PM

Well, this time they mean it. Whew, I was worried there for a second.

Bitter Clinger on July 26, 2012 at 2:54 PM

“Hello. I’m a federal bureaucrat and I’m here to sodomize help you.”

platypus on July 26, 2012 at 2:53 PM

Between TSA and HHS, I guess we all have to just relax and enjoy it.

Bitter Clinger on July 26, 2012 at 2:56 PM

The Obama administration is upping the ante in the fight against health care fraud, joining forces with private insurers and state investigators on a scale not previously seen in an attempt to stanch tens of billions of dollars in losses.
Health and Human Services Secretary Kathleen Sebelius said in a statement Thursday that the new public-private partnership “puts criminals on notice that we will find them and stop them,” …

………GREAT! 3 months before an election!…how many more people will they hire to do what they haven’t done for over 3 years?

KOOLAID2 on July 26, 2012 at 2:56 PM

So if the fed govt is gonna fight healthcare fraud … when does their assault and dismantling of the ObamascareTAX begin? Biggest piece of healthcare fraud I’ve ever seen.

stukinIL4now on July 26, 2012 at 2:56 PM

How is this a worse idea than the Florida GOP’s wasteful drug testing of welfare recipients. An endeavor that actually cost the state of Florida more money than it saved in terms of kicking users off the rolls?

libfreeordie on July 26, 2012 at 2:56 PM

It is also one of the aims before our movement to hold out the prospect of a time when the individual will be given what he needs for the purposes of his life

- Adolph Hitler

OhEssYouCowboys on July 26, 2012 at 2:56 PM

How about they start with Sen. Feinstein and her fraudulant husband?

Schadenfreude on July 26, 2012 at 2:57 PM

I dunno. Set a thief to catch a thief….

apostic on July 26, 2012 at 2:57 PM

Between TSA and HHS, I guess we all have to just relax and enjoy it.

Bitter Clinger on July 26, 2012 at 2:56 PM

…you know that somehow…it’ll be a requirement to touch our junk!

KOOLAID2 on July 26, 2012 at 2:58 PM

Medicare is farmed out to a few processors that are pretty good and maintain very large databases.

But move the issue to Medicaid (usually a 50/50 partnership between the Feds and the state) where I understand the administration is left to the state. So essentially we have 50 separate small systems with very little incentive to minimize fraud since Uncle Sam is paying for at least 50%.

I’m sure someone will chime in and correct my understanding…but if I’m right, then I think this might be a case for federal oversight since we all have a stake in what happens in any other state.

teejk on July 26, 2012 at 2:53 PM

If they’re so great, why did we need a $77 million system that caught just one fraudulent claim in 6 months?

Bitter Clinger on July 26, 2012 at 2:58 PM

It’s a good thing they exempted themselves and their families from the “seperate but equal” obamacare.

It allows them more time to focus on fraud and abuse.

acyl72 on July 26, 2012 at 2:58 PM

Hey! So, given that the entirety of ObamaTax IS essentially a fraud and colossal waste of taxpayer money, are they eliminating the whole thing?

Meople on July 26, 2012 at 2:58 PM

Recall when your Liar in Chief was going to audit the gov’t “line by line”?

“You lie” is the truest thing ever told about Obama.

Schadenfreude on July 26, 2012 at 2:59 PM

How is this a worse idea than the Florida GOP’s wasteful drug testing of welfare recipients. An endeavor that actually cost the state of Florida more money than it saved in terms of kicking users off the rolls?

libfreeordie on July 26, 2012 at 2:56 PM

…and where did you get your information?

KOOLAID2 on July 26, 2012 at 2:59 PM

Federal govt pushing to intensify fight against health-care fraud

Translation :
Hussein has received his ” contributions” and he has decided who can profit off his OTax.
Now he will eliminate their competitions.

burrata on July 26, 2012 at 3:03 PM

Oh, good: Federal govt pushing to intensify fight against health-care fraud

Cart. Horse.

Resist We Much on July 26, 2012 at 3:03 PM

Lemme guess, they’re going to start by investigating a company that was at some point in time owned by Bain Capital.

rockmom on July 26, 2012 at 3:08 PM

Details of the collaboration remain to be worked out, but the possibilities include sharing information on new fraud schemes as they pop up, using claims data to catch scams such as payments billed to different insurers on the same day for care purportedly delivered to the same patient in different cities, and using computer analysis to spot emerging patterns of fraud.

WOAH!

These ideas weren’t already being done?!? If I were going to start trying to reduce fraud, these would be some of the FIRST things I would have tried!! WTF have they been trying up until now?!?

Are they seriously telling me that it took some countless hundreds of bureaucrats some ungodly number of years of brainstroming to come up with the idea that when one of them comes across a new scam they should… maybe… ooooh, I dunno… TELL THE OTHER BUREAUCRATS TO WATCH OUT FOR IT?!?! WHEW! Those are sheer GENIUS ideas!! It’s a good thing we have Fed bureaucrats on the case! I know I couldn’t have come up with that level of friggin’ genius idea! I don’t know about you all, but I’ll be sleeping peacefully tonight!

gravityman on July 26, 2012 at 3:08 PM

fraud investigating fraud

kenny on July 26, 2012 at 3:09 PM

How is this a worse idea than the Florida GOP’s wasteful drug testing of welfare recipients. An endeavor that actually cost the state of Florida more money than it saved in terms of kicking users off the rolls?

libfreeordie on July 26, 2012 at 2:56 PM

Assuming you are correct, think of testing welfare recipients in terms of “purposes of fairness” for the taxpayers. You Liberals don’t mind when your agenda actually costs money or reduces revenue to the Treasury, as long as it is done with “fairness” in mind.

Resist We Much on July 26, 2012 at 3:09 PM

Medicare is farmed out to a few processors that are pretty good and maintain very large databases.

teejk on July 26, 2012 at 2:53 PM

If you believe that Medicare isn’t as rife with fraud as Medicaid, you’re mistaken. Medicare fraud is estimated to be $60 billion a year.

http://www.weeklystandard.com/weblogs/TWSFP/2009/10/post_145.asp

AZCoyote on July 26, 2012 at 3:10 PM

Oh goody, Dae’ be goin’ hie mo’ TSA type “investigators” to be axin’ questions an s**t cause “It’s constitutional b!shes.”

bluesdoc70 on July 26, 2012 at 3:11 PM

If a frauds such as obamacommie or subhumanelius push to eliminate fraud, isn’t that like suicide?

In their case, I’m all for it.

Wolfmoon on July 26, 2012 at 3:13 PM

2,100 page bill no one read…

… and 13,000+ additional regulations and counting being added to Obowmacare.

It’s only a matter of time when everyone will be in “violation” or guilty of “fraud” of something that we never even knew existed…

… based on some political correct social justice civil engineering ideology.

What could go wrong…?

Seven Percent Solution on July 26, 2012 at 3:17 PM

…and where did you get your information?

KOOLAID2 on July 26, 2012 at 2:59 PM

ACLU and Southern Ctr for Civil Rights no doubt.

The issue was that the state was forced to reimburse all welfare recipients for the cost of the test at $30 a pop but the savings from the cut-off benefits did not match what was paid in reimbursed test costs.

Frankly, you’d think if you were offering a contract for a few thousand drug tests, you’d get a better deal than $30 per.

Lost in Jersey on July 26, 2012 at 3:18 PM

OT (and I apologize for this, Erika) is Obama desperate and pathetic plea for cash:

In his latest fundraising pitch, President Barack Obama writes, “My upcoming birthday next week could be the last one I celebrate as President of the United States, but that’s not up to me — it’s up to you.

This July deadline is our most urgent yet, coming after two consecutive months of being significantly outraised by Romney and the Republicans.

And if you pitch in $3 or whatever you can before midnight tonight, you and a guest will be automatically entered to join me at my birthday get-together next month:

https://donate.patheticpotus.com/My-Birthday

..because, after all, it’s all about him, innit?
Thanks. Hope I’ll see you soon.

– Barack

The War Planner on July 26, 2012 at 3:20 PM

KoolAid2: http://www.nytimes.com/2012/04/18/us/no-savings-found-in-florida-welfare-drug-tests.html

libfreeordie on July 26, 2012 at 3:15 PM

If the money is going to be spent either way, whether on drug testing or on welfare for the drug user, then I would rather it was spent on the drug test rather than handed to the user so he/she can go buy more crack. At least then I know the money is going to a legit business to purchase the drug tests instead of heading to the pockets of some drug lord in a 3rd world country while contributing to the delinquency of a US citizen on it’s way there.

gravityman on July 26, 2012 at 3:21 PM

The War Planner on July 26, 2012 at 3:20 PM

Heh. It’s no wonder we hear howls of laughter emanating from the Kremlin when Barry’s name is mentioned.

a capella on July 26, 2012 at 3:29 PM

The War Planner on July 26, 2012 at 3:20 PM

Lol, I saw that earlier.

Isn’t he selling lottery tickets?

if you pitch in $3 or whatever you can before midnight tonight, you and a guest will be automatically entered

Oh, right…. it’s raffle.

Cheap, demeaning and desperate.

Cody1991 on July 26, 2012 at 3:33 PM

How is this a worse idea than the Florida GOP’s wasteful drug testing of welfare recipients. An endeavor that actually cost the state of Florida more money than it saved in terms of kicking users off the rolls?

libfreeordie on July 26, 2012 at 2:56 PM

I guess you should take that up with the private sector and the DOT. Fine for them to test and fire anyway that flunks a drug test but not OK for some welfare crackhead spawning like a rabbit and getting tax dollars to do it.

I do understand that somehow I “owe you” and you are entitled to your welfare and food stamps but don’t get all worked up about having to go find a clean friend to urintate in a bottle for you.

acyl72 on July 26, 2012 at 3:41 PM

a $77-million computer system unveiled last summer to stop Medicare fraud before it happens had prevented just one suspicious payment by Christmas.

Wow, so it only cost us $77 million to save a couple hundred bucks?

What a bargain.

AZCoyote on July 26, 2012 at 2:45 PM

These contracts should be done on a qui-tam/contingency basis. For every dollar of fraud you get, the contractor gets X% of the recovery.

blammm on July 26, 2012 at 3:45 PM

Details of the collaboration remain to be worked out

The devil is in the details, and we will never of them again if Bams wins another term.

Hey, maybe they can get some help from the bureaucrats who issued visas to the 9/11 killers…six months after they attacked us!

PattyJ on July 26, 2012 at 3:46 PM

http://www.nytimes.com/2012/04/18/us/no-savings-found-in-florida-welfare-drug-tests.html

libfreeordie on July 26, 2012 at 3:15 PM

…ALVAREZ!!!…from the New York Times!
Do you get your race relations news from Al Sharpton, and your budgetary news from Barbara Boxer?

KOOLAID2 on July 26, 2012 at 3:48 PM

…ALVAREZ!!!…from the New York Times!
Do you get your race relations news from Al Sharpton, and your budgetary news from Barbara Boxer?

KOOLAID2 on July 26, 2012 at 3:48 PM

Just because a liberal leaning newspaper says it doesn’t automatically make it false. Even Rick Scott’s office admits that they are spending more money testing people than they would be if they didn’t.

libfreeordie on July 26, 2012 at 3:50 PM

Some antifraud efforts launched with great fanfare have yet to deliver convincing results. For example, a $77-million computer system unveiled last summer to stop Medicare fraud before it happens had prevented just one suspicious payment by Christmas.

Government efficiency at it’s best!

What was the suspicious payment for $29.95?

GarandFan on July 26, 2012 at 3:56 PM

If they’re so great, why did we need a $77 million system that caught just one fraudulent claim in 6 months?

The $77 million system was Medicare (entirely Federal). We have some very crafty people in the back offices of medical facilities that are there because they make more money than they could make on the other side (akin to a good CPA will certainly outearn any IRS agent). I’m sure there is a lot of fraud there…

But IMHO the gold-mine is in Medicaid (stories abound…a Brooklyn NY dentist supposedly billed the state for what amounted to a procedure performed every 3 minutes 24/7). A few years ago the NYT (of all people) started a multi-piece story on this joke…but it mysteriously ended after a few articles.

teejk on July 26, 2012 at 4:00 PM

“Federal government against fraud” sounds like “rock against drugs” or “bees against honey”. It’s not a fight but a sparring match.

Archivarix on July 26, 2012 at 4:35 PM

Did they ever solve the problem of muliples using someone’s social security number? There must be a button that they can push down at SSA that will bring up all multiples using the same number and then the government can swoop in and arrest them. Don’t forget to bring the spanish speaking translator to read them the supposed constitutional rights they have as illegal aliens.

Buddahpundit on July 26, 2012 at 4:38 PM

Obama and Cruella already whacked $550 billion out of Medicare. If they spend $77 million to catch each over payment..There won’t even be enough left to pay for Granny and PaPa’s nite nite pill.

bluesdoc70 on July 26, 2012 at 4:41 PM

That’s not the only Obama plan that will require more federal workers and spending…

AP Exclusive: Internal documents shows Obama deportation proposal could cost more than $585M

The Obama administration’s new plan to grant temporary work permits to many young, illegal immigrants who otherwise could be deported may cost more than $585 million and require hiring hundreds of new federal employees to process more than 1 million anticipated requests, according to internal documents obtained by The Associated Press.

The Homeland Security Department plans, marked “not for distribution,” describe steps that immigrants will need to take …

batter on July 26, 2012 at 4:59 PM