Senate panel examines Medicare fraud costs

Lawmakers hear from anti-fraud professionals, concerned citizens

The U.S. Senate Special Committee on Aging is studying first-hand accounts of the financial and personal costs of Medicare fraud.

"I'm just very concerned ... that Medicare fraud has become a game of catch me if you can," Sen. Elizabeth Warren (D-Mass.) told the committee last week at a hearing. "And if you do catch me, it's just the price of doing business."

Though fiscal 2013 was a banner year for federal fraud enforcement, Medicare fraud can cost up to $90 billion annually, the Detroit News reported.

"We can't afford to lose this much of taxpayers' hard-earned dollars to fraud, and it's clear we can't arrest our way out of a problem of this magnitude," Sen. Bill Nelson (D-Fla.) said at the hearing.

Prescription fraud, for instance, is rampant in Florida as drug dealers partner with doctors and beneficiaries to cheat Medicare, according to Brian Martens, assistant special agent in charge at the Miami office of investigations. In Southern Florida, Part D investigations have nearly quadrupled in five years, Martens told the committee.

While enforcement efforts stopped some claims filed by fake clinics that operated out of storefronts, controlling this type of fraud has driven criminals to new schemes; it's like a game of Whack-a-Mole, according to The Kansas City Star.

The committee also heard from a Michigan woman who received seven months of intravenous medication infusions she didn't need for which Medicare paid more than $14,000, the Detroit News noted. Congress should find better ways to keep criminals from victimizing senior citizens like this, according to testimony by Senior Medicare Patrol coordinator Bettie Hughes.

The hearing also examined the government's use of technology to identify problem claims before payment, provider screening procedures and ways to improve anti-fraud efforts.

For more:
- watch the Senate hearing video
- see The Kansas City Star article
- read the Detroit News article

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