While listening to NPR, I heard this news story, and it really caught my attention. There is a wide variety of ways for people to make money illegally: drugs, gambling, and fraud. But, has anybody ever heard about Medicare fraud? Has anybody ever heard of people selling durable medical equipment illegally? Well, yes, it is possible. It probably sounds really lame to sell medical equipment to make tons of money, but it is in fact a huge business, and an even greater problem. Believe it or not, this year there were fraudulent Medicare claims between $300 and $400 million in only two – TWO! – Florida counties. According to an interview on NPR, there are four major reason why former drug dealers turn to selling fraudulent Medicare equipment: “‘There’s more money, there’s much less chance of being caught, and if I do get caught, I’ll be treated like a white-collar criminal, not like a drug dealer,’” and my favorite reason of all: “They’re less likely to be killed in a drive-by shooting.”
Although this sounds so strange, it is true. I feel that the Medicare system is almost inviting to fraud problems. There were several reasons given in the news story. First, that it is a “trusting system” where most claims are paid automatically – an obvious mistake. Second, that “the companies Medicare hires to handle its claims say they are working to improve fraud detection. But their main mission is not to root out fraud; it is to pay claims quickly and smoothly.” I agree with the other people interviewed in this segment: that there should be a reform of the Medicare system and how money is delegated to the system. But of course, with all reforms, it’ll be hard to do. Any suggestions?
I guess, whether you’re a drug dealer, or a wheelchair and cane dealer, there’s always going to be an easy way to get money. But, hopefully in the future, more people will act honestly and with compassion, not greedily.
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7 comments:
Although this is a nice thought, I don't see an easy way to get people to become more honest. To tell you the truth there will always be someone out there who is fraudulent whether selling drugs or Medicare equipment. All we can do is try to find ways to identify these people and try to punish them in some way.
I agree, people will always try to make money, without doing anything. I mean, who would say no to "free" money? People will always find a way to exploit the system and to profit from it. It's simple human nature to put themselves ahead of everyone else in any way possible.
I agree with Derek. Not everyone will be honest, people are always trying to do the easy thing. No matter what there will always be people doing illegal crimes to make money and we cant stop it all but we can try to stop as much of it as possible.
This might be the funniest comparison I have ever heard to drug dealing. Can you just picture a man on the corner opening up his jacket to reveal a foldable walker and cane. Anyways, I think it is a shame that Medicare equipment is so easily sold illegally. It is unfair for everyone to always think pessimistically about every claim, however from freaking Florida, I guess the health care equivalent of maybe Columbia's drug deal association, we need to start thinking about these criminals dealing illegal equipment to Americans.
The problem is that the Medicare and the private contractors paid to prevent Medicare fraud have failed miserably to keep criminals from getting Medicare supplier numbers. This has been a problem for decades. Call your members of Congress (switchboard 202-224-3121) and tell them to get serious about this problem and stop punishing every honest mom-and-pop provider of durable medical equipmennt since Congress and Medicare are taking out their frustrations on them rather than fixing the problem they are accountable for prevent. Literally thousands of legitmate providers of home medical equipment and therapies will be forced out of business over the coming year.
Medicare is required to do a site visit prior to issuing a provider number.
The fraud being perpetrated exists because Medicare never did site visits prior to issuing provider numbers as required. South Florida, among other areas, is loaded with "milling operations" that have no inventory, patients or storefront. These are small offices who do nothing but bill Medicare. They provide no equipment or services. They are only able to exist due to the complete failure of Medicare to follow it's own simple rule.
I wish people could just be honest. Imagine how much better the world would be if nobody lied of cheated anyone else.
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