America’s Safety Net
July 30, 2015 will mark the 50th anniversary of Medicare, signed into law by President Lyndon B. Johnson. Originally the brain child of President Harry S. Truman, it took 20 years from inception to enactment, and Truman was the very first recipient of a Medicare card. In 2014, 49,435,610 people received health coverage through a Medicare program. Most citizens will agree that Medicare provides a necessary safety net for our aging population. But Medicare has also opened the doors for fraudulent exploitation of older adults, becoming a cash cow for unscrupulous opportunists.
Theirs for the Taking
Typically, older adults trust and revere medical practitioners. They rely on doctors to provide advice and care that is given in the best interest of the patient. But that trust is being betrayed on a regular basis by shamelessly greedy medical professionals who use senior citizens as pawns to gain access to taxpayer dollars. To combat abuse by these corrupt doctors, nurses and other licensed health care providers, the Medicare Fraud Strike Force was established in 2007. Coordinated by the United States Department of Justice and the Department of Health and Human Services, the Strike Force has charged thousands of individuals for fraudulent billings amounting to billions of taxpayer dollars. Most recently, in June of 2015, the FBI arrested 243 individuals, charging them with a total of $712 million in false Medicare billings.
Fraud’s Many Faces
Medicare scammers have found a number of ways to get their hands on taxpayer money. According to the FBI, many schemes involve billing for medical treatments and services that are medically unnecessary and often not provided. Sometimes beneficiaries of Medicare are offered money or other perks in exchange for collusion in fraudulent schemes. Medical devices such as power chairs and glucose monitors are often advertised as free, and Medicare is billed, even when the recipient is not qualified. Medicare’s Part D prescription drug benefit program is frequently the target of fraud. Patients acquiring prescriptions under false pretenses, providers writing illegitimate prescriptions and the trafficking of counterfeit drugs are just some forms of pharmaceutical fraud, according to the Academy of Managed Care Pharmacy.
Don’t Get Punked
To avoid being victimized by Medicare crime, be aware of your rights as a patient, and become an active participant in your health care strategy. Do not give health care providers carte blanche in deciding which treatments or services your require. Ask questions and do research. If possible, find a trusted advocate to mediate in your healthcare decisions. The United States Department of Health and Human Services advises you to be suspicious of anyone who asks for your Medicare number for purposes of record keeping, or in exchange for medical devices or services. Pressure to undergo excessive tests should be questioned. Bills should be scrutinized for charges for services that were not rendered, and for treatments that you did not need or receive. To report suspected Medicare fraud, contact the Office of Inspector General at 800-447-8477, or online at medicare.gov.
References and Credits
Academy of Managed Care Pharmacy: Fraud, Waste and Abuse in the Medicare Part D Prescription Drug Benefit
Federal Bureau of Investigation: Health Care Fraud Takedown
Medicare Resources: A Brief History of Medicare in America
United States Department of Health and Human Services: Stop Medicare Fraud
*Images courtesy of freedigitalphotos.net.
