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Feds Lack System To Catch Medicare Fraud

From a seemingly surprised Associated Press:

Report: Systems to catch Medicaid fraud inadequate

By KELLI KENNEDY – Associated Press
July 12, 2011

MIAMI (AP) — The federal government’s systems for analyzing Medicare and Medicaid data for possible fraud are inadequate and underused, making it more difficult to detect the billions of dollars in fraudulent claims paid out each year, according to a report released Tuesday.

And yet Mr. Obama told us back in March of 2010 that his crackdown on Medicare and Medicaid fraud was going to save billions of dollars. In fact, Obama has claimed for years that the savings from ending fraud would go a long way towards paying for his healthcare ‘reforms.’

The Government Accountability Office report said the systems don’t even include Medicaid data.

Details, details. And never mind that the Medicaid is practically as large as Medicare these days.

Furthermore, 639 analysts were supposed to have been trained to use the system — yet only 41 have been so far, it said.

These sure sound like ‘shovel ready’ jobs.

The Centers for Medicare and Medicaid Services — which administer the taxpayer-funded health care programs for the elderly, poor and disabled — lacks plans to finish the systems projected to save $21 billion. The technology is crucial to making a dent in the $60 billion to $90 billion in fraudulent claims paid out each year

According to the Obama White House, there were (only) $54 billion dollars in improper Medicare/Medicaid payments in 2009. So the numbers have actually gone up under Mr. Obama, despite all of his promises about cracking down on fraud.

Funny how the AP doesn’t mention that.

The current antiquated database is a piecemeal system with data stored in disparate systems, meaning employees don’t have access to all data from all programs.

Each state has its own systems with very limited access to Medicare or national Medicaid data. But CMS does not have set plans to share access with the states, despite an earlier commitment to do so starting in 2010, according to the report.

The new $150 million systems, which went live in 2009, are intended be a one-stop storage for all data, accessible by all CMS staff and its contractors, law enforcement and state agencies.

But crucial pieces are still missing — including so-called "share systems data" that would help analysts identify and prevent payment of fraudulent claims, according to the report.

The agency planned to include this by 2008, but funding for the software to implement the system was delayed. CMS is now aiming for November 2011, the report said

How can funding for this have been delayed for the last three years when this was one of Mr. Obama’s top priorities and the Democrats had complete control of Congress? They can’t blame Bush for this.

Still, just wait until these same bureaucrats have complete control of your healthcare under Obama-care.

This article was posted by Steve on Tuesday, July 12th, 2011. Comments are currently closed.

11 Responses to “Feds Lack System To Catch Medicare Fraud”

  1. proreason says:

    There is no Medicare Fraud.

    It’s called Redistribution.

    That’s why it never goes down.

  2. Right of the People says:

    “These sure sound like ‘shovel ready’ jobs.”

    The only thing they’re ready to shovel is bovine excrement.

    If they can’t police Medicare, how in the heck are they going to police BarryCare?

    (That of course is a 100% rhetorical question because we all know they don’t intend to. Just another trillion dollar boondoggle for the Dimocraps’ reelection funds.)

    • jobeth says:

      Here! Here!

      I would say it takes gonads for him to tell us that “Obama no care” won’t be mismanaged and cost of Billions if not trillions in the end…not to mention rationed care, but he has none.

      Once again…just another attempt to tie America in knots. So much so that she won’t ever be viable again. That is all anything he does is trying to accomplish.

    • Rusty Shackleford says:

      I said it some time ago, that they want to “DMV” the health system. And that is putting it lightly. Everyone I know LOVES to go to the DMV and get abused, told they’re in the wrong line, tolerate “clerical errors” that cost hundreds to thousands of dollars, incompetence without a smile, surly, unhappy, poorly trained, unmotivated government workers with attitude problems, and on and on.

      Now, take all that and put grandma in their care. She needed a hip replacement…and they tell her no. So grandma is left, like Winston Churchill, in perpetual pain, for however many years she has left, but they CAN provide her with a $10,000 wheelchair. That…they say is ok.

      Cubicle monkeys who have no say…and no desire to HAVE any say….go to work at 9AM…leave at 5 and have an hour lunch (union rules). They get paid the same if they care or not. Hurray…everyone is equal. Equally miserable. Government-run healthcare DOESN’T work. There’s an ongoing argument on PJM about it and one clown keeps citing statistics published by the very nations that have the “universal” healthcare about how great it works. Jeebus….never believe the press of the entity that can write its own reviews. But he thinks if himself as very intelligent…but what he is, actually is arrogant and his head either buried so far up his bum without a nightlight, or he’s never spent a day actually working and sees everything from an “administrator’s” perspective. All about “efficiency” and “savings” and “practicality”.

      The whole thing makes me sick. Fortunately, not the kind of “sick” where I’d actually have to go see a doctor. Just morbidly nauseous. I have more days behind me now than in front of me and I’m NOT looking forward to being forced to having my senior years cut short by bureaucrats. As it is, I have figured out that I have to work until I’m 131 years old….then I can retire and live a peaceful life. So maybe, they’ll just be forced to keep me alive so I can continue to pay their salaries.

    • jobeth says:

      Rusty…I’m so fearful of the Obama ‘no’ care that since Dec 2010 I’ve made it my business to get as much medical care possible before its yanked out from under me. I’ve put off too long things that I need done but no longer.

      Dec I had abdom. surgery…March I had my back fixed. Mid Aug I’m having both knees replaced and If I can, I am going to squeeze in needed reconstructive surg I’ve put off, before year’s end (no y’all not a face lift…lol there isn’t enough fish line for that…lol) .

      Why? Because I’ll be 67 by year’s end and I’ll fit nicely in his…”no… not important enough for what it will cost”.

      Would I have died if I hadn’t done it? No but I’ve needed it badly…I hurt all the time. However…in my mid sixties it will mean that a kid with sniffles will get to see the doc but I will have to wait…and wait…and wait…and… I’ve seen this happen too often in the UK already.

      My sis in law also needs one of my surgeries and has been refused…Clearly needs it but no. She has to live with it. And if she did get it…she would be in an open ward of multiple pts. They don’t give their reg pts private or simi private rooms…costs too much. Instead they allow them to stay in big rooms with multitudes of diseases to share. Uggg.

      I bought extra insurance via the Advantage plan…and don’t mind at all. Its my body and I don’t mind paying for good care. Obama wants to kill that Advantage plan and make us depend on single payer…ie the gov.

      I don’t know what each new year will bring with Obama working against us and mandating the insurance companies to jump through more and more hoops until they go broke. I just hope I can get it all done before that happens.
      Then I’ll pray I stay healthy till I die a nature death of old age.

      My biggest hope and prayer is that we can give this monster Obalmy Plan the boot. But I can’t take that risk. I’d kinda like to live…and with a good quality of life…go figure.

  3. Papa Louie says:

    So Democrats deliberately lied to us to get Obamacare passed. When they took $500 billion from Medicare to pay for Obamacare, they promised the money would come from “cutting $500 billion in waste, fraud, and abuse from medicare”. But they are not even trying to keep that promise. When is the country going to learn not to trust Democrats?

  4. canary says:

    “The new $150 million systems” How many systems?

  5. P. Aaron says:

    Feds do seem to have a system to surf porn all day.

  6. jobeth says:

    If you or I were to buy a motorized wheel chair with our own money…the cost would be $2000 to $6000 or within that range. (That’s ridiculously high but that’s just my opinion). They run about $500 used and in very good condition.

    A family member got one via Medicare. They were dictated to as to which brand and model they could have and who would provide that chair. NO CHOICE for her to look around for the best buy or style that would better fit her needs.

    Once the man from the Health care service was finished he handed her a receipt for her to sign and gave her a copy. Later she was looking at it. You want to know how much you and I paid for this thing?

    Over $10,000 dollars!!!! Explain why that wouldn’t raise a few eyebrows in DC?
    Even though she knew this was nothing more than gouging the taxpayer she was afraid to say anything because she was afraid they would remove it and she needed it too badly.

    Once again, if we had to pay for it ourselves…that price would come down in a heartbeat because none of us would pay those outrageous prices out of our own pockets…we couldn’t afford to.

    $10,000 would buy you a motorized wheelchair…or a car…Please explain to me how these two are comparable?

    • proreason says:

      You can buy one of those scooter chairs new for around $500.

      Walmart has a motorized wheelchair listed right now for $1,949. Google shows another new one for $1,049. That means you could probably find one for $600-800.


    • jobeth says:

      There you go then…my point even more so.

      I think a lot depends on if you get a heavy duty one or a lightweight one.
      She only wanted a light weight one that she could get in and out of small spaces and had one in mind. Nope…no dice…take the one they wanted to give you or no deal.

      So she got the high end…larger, heavy duty chair…like it or not.

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