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Have you heard about the zombie doctors? No, it's not a horror movie, but they're scary all the same. Last year, a Senate report revealed that in the previous seven years, the federal Medicare program had paid as much as $92.8 million for about a half-million claims submitted in the names of doctors who were six feet under. The charges were for medical supplies, ranging from wheelchairs to prescription drugs. One pair of scam artists in Florida used the Medicare identification numbers of dead docs to bilk $1.3 million from the government—also known as we the taxpayers.
More than 50,000 of the bogus claims involved doctors who had been deceased for at least ten years. Despite a warning from the Department of Health & Human Services (HHS) in 2001 about exactly this problem, tough safeguards were never put in place.
The National Health Care Anti-Fraud Association estimates that more than $60 billion a year is lost to fraud—or 3 percent of federal health-care spending.
Here's another good one: the podiatrist who allegedly billed the government for treating people with no feet. Dr. David Quang Pham was indicted in St. Louis this past June for charging the government for nonexistent procedures that he backed up with phony notes (Pham has pleaded not guilty). As an unforgettable press release from the local U.S. Attorney's office put it, "Dr. Pham submitted reimbursement claims for treating the feet of patients whose feet had been amputated prior to the dates of service." And once again, it was the taxpayer who had to, er, foot the bill.
Unfortunately, the bigger issue here is no joke. Prosecutors across the country are scrambling to keep up with an epidemic of fraud and abuse?in our public health-care system. As President Obama seeks to reform health care, honest people can disagree about the best approach. But there's no disputing one important truth: Shocking amounts of money are stolen by crooked doctors and scammers, and that's driving up costs for all of us. The National Health Care Anti-Fraud Association estimates that more than $60 billion a year is lost to fraud—or 3 percent of federal health-care spending. Think of how all that money could improve, extend, or outright save lives.
With health-care reform at center stage, it's a perfect opportunity to take action. But the government has dropped the ball before. In the 16 years that his group has been around, says Dennis Jay, executive director of the Coalition Against Insurance Fraud, fraud prevention has gone from "abominably bad" to "very weak." He adds, "It still has a long, long way to go for taxpayers to feel comfortable that their dollars are being well spent." True change may take some time. But here's one small step Washington could take right away to restore some confidence:?Make sure that doctors collecting our dollars still have a pulse.