From: olivercranglejr@gmail.com   
      
   America lost between $82 billion and $272 billion to medical fraud in 2011    
   Фото: РИА Новости    
   According to Donald Berwick, the ex-boss of Medicare and Medicaid, America   
   lost between $82 billion and $272 billion in 2011 to medical fraud and abuse.   
   The higher figure is 10% of medical spending and a whopping 1.7% of GDP which   
   is equal to the entire    
   output of Tennessee or nearly twice the budget of Britain’s National Health   
   Service.    
      
   After all, Dr Berwick's study found that administrative complexity and   
   unnecessary treatment waste even more health dollars than fraud does.    
   American health care is a kindly soil for such speculations for several   
   reasons. First, no other country spends nearly as much on medications and   
   procedures. Second, it is barely guarded.    
   Investigators in New York were looking for health-care fraud hot-spots. Agents   
   suggested Oceana, a cluster of luxury condos in Brighton Beach. The 865-unit   
   complex had a garage full of Porsches and Aston Martins-and 500 residents   
   claiming Medicaid, which    
   is meant for the poor and disabled. Though many claims had been filed   
   legitimately, some looked iffy. Last August six residents were charged. Within   
   weeks another 150 had stopped claiming assistance, says Robert Byrnes, one of   
   the investigators.    
   The fraud schemes may be simple. Patients claim benefits to which they are not   
   entitled; suppliers charge Medicaid for non-existent services. As an example a   
   doctor was recently accused of fraudulently billing for 1,000 powered   
   wheelchairs in LA. Also    
   there are more complicated schemes that involve syndicates of health workers   
   and patients. Shady dealers are looking for old people willing, for a few   
   hundred dollars, to let pharmacists supply their medications but bill Medicare   
   for much costlier ones.    
   Criminal gangs are switching from cocaine to prescription drugs - the income   
   is equal, but with less risk of being arrested. One clinic in New York   
   allegedly wrote bogus prescriptions for more than 5m painkillers, which were   
   then sold on the street for $   
   30-90 each. Identity thieves have realized that medical records are more   
   valuable than credit-card numbers. It is much easier to notice that a credit   
   card is stolen than detect that someone else uses a photocopied Medicare.    
   Medicare's contractors process 4.5m claims a day which makes it hard to make   
   the system secure. But pointless complexity makes it even harder. Fraud   
   experts have long asked the government to remove Social Security numbers from   
   Medicare cards to deter    
   identity thieves but it took no effect. Next year Medicare will have 140,000   
   billing codes, including ten for injuries that take place in mobile homes and   
   nine for attacks by turtles.    
   More than that, there is a lack of resources for investigations. New York has   
   a Medicaid investigations division of 110 people which includes support staff   
   to inspect $55 billion of annual payments and 137,000 providers. Gloria   
   Jarmon, an auditor with    
   the HHS, told a recent hearing that budget cuts will probably force it to cut   
   its oversight of Medicare and Medicaid by 20% in this fiscal year.    
      
      
      
   http://voiceofrussia.com/2014_06_06/America-lost-between-82-bill   
   on-and-272-billion-to-medical-fraud-in-2011-3586/    
      
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