Healthcare Fraud – The Right Storm

Today, healthcare fraud is all around the news. There unquestionably is fraud in healthcare. This is also true for each business or endeavor touched by human hands, e.g. banking, credit, insurance, politics, etc. There’s no doubt that medical service providers who abuse their position and our trust to steal really are a problem. So might be individuals using their company professions that do exactly the same.

How come healthcare fraud appear to obtain the ‘lions-share’ of attention? Can it be that it’s the perfect vehicle they are driving agendas for divergent groups where taxpayers, healthcare consumers and medical service providers are dupes inside a healthcare fraud covering-game operated with ‘sleight-of-hand’ precision?

Take particular notice and something finds this really is no game-of-chance. Taxpayers, consumers and providers always lose since the trouble with healthcare fraud isn’t just the fraud, but it’s our government and insurers make use of the fraud problem to help agendas yet still time neglect to be accountable and be responsible for any fraud problem they facilitate and permit to flourish.

1.Astronomical Cost Estimates

Believe to set of fraud then to tout fraud cost estimates, e.g.

– “Fraud perpetrated against both private and public health plans costs between $72 and $220 billion yearly, growing the price of health care and health insurance undermining public rely upon our overall health care system… It’s no longer a secret that fraud represents among the fastest growing and many pricey types of crime in the usa today… We pay these costs as taxpayers and thru greater medical health insurance premiums… We have to be positive in combating healthcare fraud and abuse… We have to also make sure that police force has got the tools that it must deter, identify, and punish healthcare fraud.” [Senator Ted Kaufman (D-DE), 10/28/09 pr release]

– The Overall Accounting Office (GAO) estimates that fraud in healthcare varies from $60 billion to $600 billion each year – or between 3% and 10% from the $2 trillion healthcare budget. [Healthcare Finance News reports, 10/2/09] The GAO may be the investigative arm of Congress.

– The Nation’s Healthcare Anti-Fraud Association (NHCAA) reports over $54 billion is stolen each year in scams made to stick us and our insurance providers with fraudulent and illegal medical charges. [NHCAA, web-site] NHCAA was produced and it is funded by medical health insurance companies.

Regrettably, the longevity of the purported estimates is dubious at the best. Insurers, condition and federal agencies, yet others may gather fraud data related to their personal missions, in which the kind, quality and amount of data compiled varies broadly. David Hyman, professor of Law, College of Maryland, informs us the broadly-disseminated estimates from the incidence of healthcare fraud and abuse (assumed to become 10% of total spending) lacks any empirical foundation whatsoever, the small we all do learn about healthcare fraud and abuse is dwarfed in what we do not know and just what we all know that isn’t so. [The Cato Journal, 3/22/02]