July 16, 2010

36 Arrested in Medicare Scams Totaling $251M - NYTimes.com

36 Arrested in Medicare Scams Totaling $251M - NYTimes.com

Let's hope this crackdown is the beginning of serious efforts to thwart Medicare and other criminal fraud that has allowed people to bilk the U.S. Government out of untold $billions over the years. What's needed is real-time processing of claims that can be bounced against a database of existing claims and payments so that patterns of suspicious activity can be revealed right away. Treasury or NSA has algorithms that would make this child's play. It seems  the Medicare folks have finally begun to use them.

More actions like this are required to restore confidence in Government. Now if the Feds would only get serious about illegal immigration...

"...Federal authorities launched a strike force in Miami in 2007 to target the problem. The program has since expanded to seven cities and is responsible for more than 720 indictments that collectively have billed the Medicare program for more than $1.6 billion.

Miami-Dade County received about $520 million from Medicare in home health care payments intended for the sickest patients in 2008, which is more than the rest of the country combined, according to a federal report. Only 2 percent of the patients live here.

It used to take 90 days before the government detected a scam. By then, the crooks were long gone, sometimes with millions of dollars. Now authorities get billing data as it's submitted, allowing them to catch suspects in real time, ''as opposed to the typical pay and chase model we've had for years,'' said Gerald Roy, assistant inspector general for investigations."
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