No. of Recommendations: 1
You can't filter out the deserving and undeserving from each other, because the process of making that kind of individualized assessment is not only itself very expensive, but also ends up throwing tons of deserving people off the program. - albaby------------------
Turns out some fraud can be filtered and identified. I think it is good to perpetually be looking for them, and aggressively prosecuting fraud with lots of publicity. DOGE style of data mining opens up new opportunities for detection.
This example shows that some (most) of the criminals perpetrating medicare fraud are not necessarily medicare recipients themselves.
https://www.wisn.com/article/feds-charge-11-in-106...
The charges stem from a Department of Justice announcement of 324 people charged in connection to more than $14 billion in fraud.Now, the United States DOJ says it has charged 11 people in the scheme. Court records show an overseas crime ring put foreign nationals in charge of companies in the United States as straw owners. The group then billed Medicare for urinary catheters and other medical supplies using "... the stolen identities of over one million Americans spanning all 50 states ..."
"A lot of this is truth and trust," said Mary Kogelmann, who received a summary notice showing Medicare paid for a catheter on her behalf. "As far as I'm concerned, there is no truth in a lot of this. It's nothing but fraud and lies."
Kogelmann never requested or received a catheter.
"I was shocked," said Chuck Wurster, who had a notice showing Medicare paid thousands on his behalf for catheters he didn't want or receive. "Absolutely shocked to see that with the vast amount of money that was being taken in by these people."
Court records show the crime ring mainly operated in Russia and Eastern Europe.
"Every fraudulent claim, every fake billing, every kickback scheme represents money taken directly from the pockets of American taxpayers," said Matthew Galeotti of the Department of Justice.
DOJ says Medicare stopped the payments to most, saying the federal agency paid $41 million, and supplemental insurance companies paid roughly $900 million in the scheme.
12 News Investigates has spoken to more than 80 people who had fraudulent claims. Court records show more than 400,000 people made the same complaints to the Centers for Medicare and Medicaid Services.
These arrests are part of a larger announcement made by the DOJ Monday saying it arrested 324 people in connection with more than $14.6 billion in fraud.
