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Dead Doctors Used to Scam Government Out Of Medicare Money

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From 2000 to Medicare paid out $93 million of government money for fraudulent claims….

A report made by the Senate Homeland Security investigations subcommittee found as much as $93 million dollars may have been lost in fraudulent Medicare claims from 2000 to 2007.

The probe found that many reimbursement claims for wheelchairs, drug prescriptions and other medical supplies were based on prescriptions signed for by doctors who were actually dead.

Congressional investigators say that unless Medicare officials address flaws that they’ve promised to fix since at least 2001, millions more dollars will continue to be at risk of waste and fraud each year in the billion-dollar government-run health program for the elderly and disabled.

medical claims 2 Dead Doctors Used to Scam Government Out Of Medicare Money

The bipartisan report, obtained by The Associated Press in July last year, found that Medicare paid out between $60.3 million to $92.8 million to medical suppliers even though the claims came from doctors who had been listed dead for at least 12 months.

The report revealed that in Florida alone, 114 ‘deceased’ doctors claimed more than $2 million from 2002 to 2007 for medical supplies including oxygen machines, prosthetics and diabetic equipment.

One single deceased doctor who died in 1999, was found to have made as many as 484 claims totaling $544,789.

The probe also found that 7% of all deceased doctors and 27% of dead doctors in Florida, still had active Medicare ID codes that could be used to make fraudulent claims.

The Centers for Medicare and Medicaid Services and its contractors had switched to new ID system in May last year, but the investigation still warned that unless broader changes are implemented, the same potential problems of fraud may rise again.

In response to the report, CMS did not deny the findings, but said it was taking steps to avoid future problems. The agency said it was working to strengthen federal regulations and the documentation required to claim reimbursements, it also plans to work closely with the Social Security Administration to get monthly updates of the agency’s file on recent deaths.

Herb Kuhn, deputy administrator of CMS, wrote in the report:

“We believe the initiatives we have initiated will address many if not all of the issues surrounding the payments for claims to those health care providers who are using invalid or inactive physician numbers.”

The Senate now calls for CMS to adopt new procedures that would see that update of physicians’ data on a more frequent basis, such as every 90 days instead of every 15 months. Sen. Norm Coleman, R-Minn., the top Republican on the Senate panel said:

“Using the ID numbers of dead doctors, these scam artists have treated Medicare like an ATM machine, drawing money out of the government’s account with little fear of getting caught,”

In one case, Miami-based Professional Gluco Services Inc. submitted 83 questionable claims between December 2005 and July 2006 and was paid $93,171, according to the report. Last November, Gluco’s owners pleaded guilty to criminal charges of submitting claims for medical equipment that had not been ordered by a doctor nor delivered to a Medicare patient.

“The slipshod procedures that let these claims get through are an insult to U.S. taxpayers,” said Sen. Carl Levin, D-Mich., who chairs the Senate panel. “It is long overdue to shut the door on this multi million-dollar abuse.”

Coleman explained that the estimated loss would be much higher if investigators included doctors who had been dead for under 12 months.

“It’s time to close this $100 million loophole.” He added.

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