On July 21, the Government Accountability Office (GAO) published further details of its investigation into the system procedures being used by Medicare and Medicaid to establish potential fraud and abuse. They found that 2 particular procedures – (i). verification of provider practice location, and (ii). physician licensure status – may not be working properly. The fiscal year (FY) of 2014 saw Medicare pay out over $554 billion for healthcare and healthcare-related services, of which a staggering $59.9 billion (or 10.8%) of the payments were found to be incorrect. Thus, the Office of Management & Budget has now classed Medicare as a “high-error” program, simply because of the large amount of money involved.
The GAO estimates there may be 23,400 potentially fraudulent addresses being used by so-called healthcare providers enrolled as such in the Medicare system. Sampling 496, they found 46 of these were allowed to enroll using nothing more than a P.O. Box number inside a mailing store as the physical address for their practice. The mailing store can provide users with a suite or alternative number, a street name and a business district, as opposed to the simple P.O. Box number itself.
The $59.9 billion incorrectly paid in FY 2014 was higher than that revealed for the previous year. Therefore, it is clear the problem is worsening, and equally clear nothing, if anything, is being done to find a resolution. If you are seriously concerned about the issues arising from the GAO’s mounting evidence, please Like & Share this post.
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US Government Waste
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