Fraud has long plagued the sprawling, $427-billion-a-year Medicare health program for seniors. But on Wednesday, a just-released congressional investigation initiated by Minnesota Sen. Norm Coleman detailed a new and outrageous low that should have taxpayers sputtering in outrage.
Since 2000, scammers using the billing identities of dead doctors have bilked the federal program out of as much as $92 million. To make matters worse, Medicare became aware of the problem in 2001, promised to fix it, and then kept honoring claims from thousands of deceased physicians. In some cases, the doctors had died years before.
"The sad truth is that the Medicare system is vulnerable to fraud. The suppliers simply figured out that there isn't a guard at the front gate to prevent improper payments," Coleman told the Star Tribune. Coleman, a Republican, was chairman of the Senate's Permanent Subcommittee on Investigations when he launched the probe in 2006 with Sen. Carl Levin, D-Mich.
Most of the fraud centered on items known as durable medical equipment -- wheelchairs, oxygen and other home equipment. To Medicare watchdogs, that didn't come as a surprise. There have been concerns for years about fraud by suppliers of these goods. The Government Accountability Office reviewed billing practices for fiscal 2004 and found that Medicare improperly paid $900 million for durable medical equipment. Sometimes, Medicare had reenrolled fraudulent suppliers three months after revoking their billing privileges.
These so-called businesspeople should have been in jail, not back in the system and certainly not dragging the honorable names of innocent, dead doctors and their families through the dirt in ever-expanding scams. According to the Coleman-led investigation, the identities of as many as 274 of Minnesota's deceased physicians may have been abused. Investigators are now pursuing criminal charges against some of the alleged scammers.
Policymakers should consider strengthening criminal penalties for this type of activity, as well as the need for broader, more frequent fraud investigations. Apparently legions of people thought nothing of ripping off a noble, taxpayer-funded program aiding the elderly and disabled. Would better enforcement and harsher punishments deter them? It's worth discussing.
If the Medicare program were an actual patient, this investigation would be the latest symptom indicating a grim prognosis. The program faces severe funding shortfalls in years ahead as baby boomers retire. Congress is currently considering emergency action to stave off a 10.6 percent cut in physician reimbursements; without it, many doctors may stop seeing Medicare patients. The program wastes vast sums of money on unproven drugs and procedures. And it penalizes those who provide good care at low cost (Minnesota doctors) while rewarding those who simply do the most procedures.
Coleman, Levin and other Medicare watchdogs deserve praise for documenting yet another serious problem and initiating steps to end it. This bipartisan effort inspires confidence that lawmakers can go forward from here to tackle Medicare's other woes and nurse the program back to health.
