| 摘要 | Health-care fraud is enough to make you sick: kickbacks, money laundering, identity theft, criminals peddling Medicare numbers for profit, bills for home-health services that never happened, HIV drugs, make-believe medical equipment, you name it.
In July, the Department of Justice’s Medicare Fraud Strike Force charged 94 doctors and medical executives for more than $251 million in health-care fraud in cities around the country. These charges stemmed from schemes involving physical therapy, home health, HIV infusion, durable medical equipment, fraudulent billing and kickbacks.
In Florida this year, the FBI tracked and ultimately charged a Miami-Dade man who pleaded guilty to submitting $11 million in false claims to Medicare for HIV services never provided.
The list goes on.
These schemes steal as much as $100 billion a year from Medicare and Medicaid alone. That amounts to more than $300 for every man, woman and child in America. This is money that could be spent to keep America’s families healthy. Instead, it’s going to those who, for too long, have profited by stealing from resources dedicated to providing health care to older Americans.
This is an epidemic, and we want to stop it.
We all have a responsibility to use the power that comes with standing together to battle health-care fraud. All stakeholders can take these steps:
Advocating for much wider use of technologies that enhance our ability to detect scams before bills are paid, ensuring that criminals, once identified, can never defraud again. Health care is well behind such industries as banking and credit cards in embracing modern tools that flag and prevent misconduct in real time. We have to get better at using data to uncover questionable transactions and trends.
Calling on private and government insurers–Medicare and Medicaid–to do more. Consumers need easy-to-read information, along with greater security for their medical records. Forms such as insurers’ Explanation of Benefits should be simplified. Consumer complaints should be acknowledged and acted on promptly.
Offering guidance on how to recognize and report fraud. Medical bills can be complex. Our organizations help people recognize what to look for and, if they find something fishy, where to report it. We urge Americans to protect their Medicare and Medicaid identification numbers as carefully as they do their Social Security cards.
We salute efforts by the federal government’s Medicare Fraud Strike Force, which has uncovered more than $1.85 billion in alleged fraud since its inception in March 2007. But law enforcement can’t do this job alone. Indeed, we agree with Health Secretary Kathleen Sebelius who said at the first National Summit on Health Care Fraud in January, “We believe the problem of health-care fraud is bigger than government, law enforcement or private industry can handle alone.”
Our two organizations, AARP and the Center for Health Transformation, are working to shine a light on health-care fraud and its impact on all Americans.
We look forward to collaborating with others, sharing intelligence and promoting the lessons we learn.
The pressure on health-care costs is intense. In just a few months, the first of the post-war baby boomers will reach age 65 and qualify for Medicare. Cleaning up the health-care system is an important part of making sure that tomorrow’s seniors–and young people, too–will be able to afford the care they need.
Until now, con artists have been able to exploit a climate of ignorance, apathy and outdated technology. We want those days to end. Working together, we can make a difference in health-care fraud.
Newt Gingrich is a senior fellow at AEI. A. Barry Rand is the CEO of AARP.
Photo Credit: iStockphoto/Kameleon007 |
