{"id":2180384,"date":"2024-02-20T03:36:01","date_gmt":"2024-02-20T08:36:01","guid":{"rendered":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/fixing-medicare-starts-with-cracking-down-on-a-multibillion-dollar-catheter-scam\/"},"modified":"2024-02-20T03:44:36","modified_gmt":"2024-02-20T08:44:36","slug":"fixing-medicare-starts-with-cracking-down-on-a-multibillion-dollar-catheter-scam","status":"publish","type":"post","link":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/fixing-medicare-starts-with-cracking-down-on-a-multibillion-dollar-catheter-scam\/","title":{"rendered":"Cracking down on a costly catheter scam is key to fixing Medicare"},"content":{"rendered":"

24<\/div>SHARES<\/span><\/div>

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Stop \u2062me if you\u2019ve heard this\u200c one before: \u200bA\u2063 government program\u2063 is rife with fraud. After \u2062years\u2019 worth \u2062of stories\u2062 about scams during Washington\u2019s Covid-19 spending\u2064 binge \u2014 bogus pandemic-related unemployment benefits\u2064 totaled an estimated $100-135 billion<\/a>,\u2062 according to a Government Accountability Office report<\/a> \u2062 from last fall \u200b\u2014 now the scammers \u200bare hitting up Medicare (again).<\/p>\n

The New York \u2063Times reported recently<\/a> about a sharp spike in \u2064Medicare spending on catheters, amid numerous signs that scammers have targeted\u2063 that benefit to\u2062 bilk the government out of taxpayer funds. With Medicare rapidly approaching insolvency, \u2062the\u2063 problem is twofold: \u200bCriminals still consider \u2064the program such an easy source \u2063of cash \u2014 because the feds do such a poor job at \u200bfinding and catching the \u200ccrooks. <\/p>\n

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Obvious Spending Pattern<\/h2>\n
Times\u200b reporters\u2063 interviewed several \u200cseniors\u200c explaining how they\u2063 had been\u2062 billed\u200c for catheters they never received and do not need or \u200cuse.\u200c It also noted that the \u2062number \u200cof Medicare beneficiary accounts billed for catheters rose roughly nine-fold last year, \u200dfrom 50,000\u2062 to 450,000. <\/p>\n
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New York Times<\/a> \/
Fair use<\/p>\n<\/p><\/div>\n<\/div>\n
The pattern of Medicare spending on \u200bcatheters\u200b echoes the increase in beneficiaries billed. Based on this graph from the Times story,\u200b it doesn\u2019t take a\u2063 doctorate in economics to realize that something fishy\u200d has \u2063happened regarding payments for\u2063 catheters \u2014 \u200band that, assuming most or all of \u2063the increase is due to fraud, Medicare has already \u200dgiven the scammers billions of dollars.<\/p>\n
Over and above whether and when the feds can catch \u200bthe scammers,\u2062 the real \u2063question is: How did this happen? Or, given the federal \u2064government\u2019s history \u200bof permitting fraud in federal health care programs<\/a>, how does \u200dthis keep happening?<\/p>\n
Obvious Signs<\/h2>\n
Several elements of \u2063the Times story stand out as illustrations of the federal government\u2019s incompetence at catching fraud. For starters, the data for the graph\u200b above \u200dcame from a report issued\u200d by the National Association of \u200dAccountable Care Organizations, a\u2062 private \u200cnonprofit. <\/p>\n
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Therein \u200blies an\u200b obvious question:\u200b Why \u200cisn\u2019t Medicare analyzing data and publishing these \u200dtypes of reports to alert senior citizens about the latest\u2063 scam making \u200bthe rounds?\u2063 Granted, the private \u2063entity that \u2064did\u2062 the analysis used data that Medicare has \u2062in recent years \u2064published online, to make \u2064more information available to researchers.<\/p>\n
But it shouldn\u2019t take a year, and billions of \u2064dollars in potentially fraudulent spending\u200d out the door,\u2064 before\u200d Medicare gets its \u200cact together and cracks down on\u200b scams. Other elements of the Times story\u2064 also demonstrate that \u200cmany private entities have\u2062 known about this increase in catheter-related fraud for months.<\/p>\n
For \u200binstance, a Nashville business \u2064that coincidentally shares the same \u2062name as\u2064 one of the companies running this apparent\u200d scam has received so many complaints from irate seniors that she created \u200ba page on her website<\/a> indicating that her firm has nothing to\u2064 do with the scam and instructing seniors how to\u200d take action to \u2063report fraud. According to\u2063 the Times, the owner of \u200cthe legitimate business \u201ccalled in a complaint to \u200bMedicare in September \u2026 but the barrage of \u2063phone\u2063 calls has not stopped.\u201d<\/p>\n
In another example, \u200bone physician member of an accountable care\u2064 organization filed a complaint with the inspector general\u200d in December, after his patients were billed\u200c $2 million last year \u2062for catheters they \u2064did not need or use: \u201cI just\u2063 know that it\u2019s\u200b all fraud because our doctor \u200cdidn\u2019t\u200d order it and our patient never got it.\u201d<\/p>\n
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Finally,\u2064 back \u2063in July, the Oklahoma insurance commissioner\u2019s office noticed a suspicious\u200d pattern\u2063 regarding catheters while investigating fraud related to Covid-19 testing: \u201cWhen we started\u2064 asking seniors, they told us they had \u200cnever used urinary \u200dcatheters \u200band didn\u2019t know why the claims were there.\u201d<\/p>\n
The question practically asks itself: If all these people knew something suspicious was going on, why on Earth didn\u2019t \u200cMedicare do anything about it? Since the Oklahoma insurance commissioner\u2019s office\u2062 got suspicious in July, Medicare\u200c has paid out at least an additional \u2062$1.5 \u2062billion in catheter claims\u2064 \u2014 most \u2062of which are likely fraudulent. How many more billions must the scammers steal before the federal government finally acts?<\/p>\n
Stop the Medicare \u2064Steal<\/h2>\n
As\u200d I laid out in my book<\/a> The\u2062 Case Against Single Payer<\/em>,\u2064 those \u200cwho\u2062 claim government-run systems hold more efficiencies than the private sector fail to account for the billions \u2014 quite possibly tens or hundreds of \u2062billions \u2014 of\u2062 dollars in\u200b fraud\u2063 that plague programs\u200b like \u200bMedicaid and Medicare. Private-sector companies wouldn\u2019t see \u2062the type of billing \u200bpattern seen for\u2063 catheters \u2014 with spending \u200cgoing\u2062 straight up for over a year\u200b \u2014\u200b without asking far more questions about potential fraud far sooner, that\u2019s for sure.<\/p>\n
With the\u200d federal \u2062government $34 trillion in debt and Medicare already functionally insolvent<\/a>, it\u2019s long past time<\/a> for the federal government to get serious about \u2064fighting \u2062fraud. \u2063Medicare does need structural reforms \u2014 reducing or eliminating fraud probably won\u2019t make the program solvent \u2062on its own. But stopping\u2064 the scammers is the \u2064most logical\u2064 place to start.<\/p>\n
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\t\t\t\t\t \t\t\t\t\t\t\t\t\t<\/div>\n
\u200drnrn <\/p>\n
\u200cHow has the\u200d government’s incompetence in detecting fraud contributed to the \u200bincrease in fraudulent billing for catheters?<\/h2>\n
Title: Medicare Fraud: \u200dAn \u2064Ongoing Challenge \u200bfor the U.S\u200b Government<\/p>\n
Introduction:<\/p>\n
Fraud within government programs has become an all too familiar problem, and\u2063 it seems that no sector\u200d is \u200dimmune. After the \u200bimmense scale\u2062 of fraud\u2064 during Washington’s Covid-19 \u2064spending spree,\u2064 which saw an estimated $100-135 billion being stolen, scammers\u200d have again set their sights on Medicare. The New York Times recently reported a \u2064concerning spike in \u200bfraudulent billing for catheters, highlighting the\u2063 ongoing\u200d challenges \u2062faced by the government in tackling fraud within \u2062healthcare programs.<\/p>\n
Obvious Spending Pattern:<\/p>\n
The New York Times interviewed several seniors who \u2063were\u200d billed for catheters they never received or\u200b needed. This increase in fraudulent \u2062billing is corroborated by a nine-fold rise in the number\u2064 of Medicare beneficiary accounts billed for catheters from 50,000 \u2062to 450,000. The\u200c glaring pattern suggests that Medicare\u200b has\u200c unwittingly given scammers billions of dollars, raising questions about the effectiveness of fraud prevention measures.<\/p>\n
Incompetence at Catching Fraud:<\/p>\n
There are several indications in the Times report\u2062 that \u2064shed light\u2064 on\u200c the government’s incompetence in \u2062detecting fraud. Firstly, the data for the graph displaying the surge in catheter-related fraud came from a report by the National Association of Accountable\u2063 Care Organizations,\u2062 a private nonprofit. This begs the question of why Medicare did not analyze and publish\u200d such data to notify\u2062 senior citizens of the latest scams.\u2064 While \u200cprivate entities have been aware of the increase in fraud for months, it took too long for Medicare to\u200d take action, resulting in potentially billions of dollars being wasted.<\/p>\n
Private entities, such as a Nashville business falsely associated with the fraudsters, have\u2062 received numerous complaints from seniors and\u2062 have\u2062 had to create dedicated\u2062 webpages to refute their involvement. One physician member of an accountable care organization filed a complaint\u200d with the inspector general after his patients \u2063were\u2062 wrongly billed $2 million for \u200dcatheters they neither needed nor used. These\u2064 instances demonstrate that\u200c private entities have \u2063been proactive \u2063in their efforts to combat\u2063 fraud\u200c while highlighting the government’s failure to take\u200d prompt\u200b action.<\/p>\n
The Need for Swift Action:<\/p>\n
The federal government must address the glaring inefficiencies in its fraud detection and prevention efforts. While Medicare has\u2063 made some efforts to publish data online, it must do \u200bmore to analyze and disseminate information to protect vulnerable beneficiaries. The collaboration of private entities and the government is crucial in curbing fraud and safeguarding taxpayer funds<\/a>.<\/p>\n
Conclusion:<\/p>\n
The Medicare fraud involving catheters serves as a grave reminder of the ongoing challenges faced<\/a> by the U.S. government in combatting fraud within its healthcare programs. \u2064The government must prioritize efforts to improve fraud detection, streamline reporting mechanisms, and enhance collaboration with private entities. Failure to do \u200dso\u2062 will only perpetuate the cycle of fraud and waste,\u2063 ultimately\u2063 jeopardizing the financial\u2063 health of Medicare \u200dwhile betraying \u2062the trust of American taxpayers and beneficiaries alike.<\/p>\n","protected":false},"excerpt":{"rendered":"
Government programs plagued by fraud are nothing new. Washington’s Covid-19 spending spree saw an estimated $100-135 billion in fraudulent pandemic-related unemployment benefits, as per a Government Accountability Office report. Now, scammers have turned their attention to Medicare, continuing the trend of exploiting vulnerable systems for personal gain<\/p>\n","protected":false},"author":521,"featured_media":2180385,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_mo_disable_npp":"","fifu_image_url":"https:\/\/thefederalist.com\/wp-content\/uploads\/2024\/02\/Urinary-catheters-03.jpeg","fifu_image_alt":"","footnotes":""},"categories":[546],"tags":[],"class_list":["post-2180384","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-the-federalist"],"fifu_image_url":"https:\/\/thefederalist.com\/wp-content\/uploads\/2024\/02\/Urinary-catheters-03.jpeg","_links":{"self":[{"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/posts\/2180384","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/users\/521"}],"replies":[{"embeddable":true,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/comments?post=2180384"}],"version-history":[{"count":0,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/posts\/2180384\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/media\/2180385"}],"wp:attachment":[{"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/media?parent=2180384"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/categories?post=2180384"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/tags?post=2180384"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}