"An aggressive assault on Medicare fraud, waste and abuse produced $7.6 billion in savings in fiscal 1997 and removed nearly 3,000 'unsuitable' health care providers from the system," according to a Gannett News Service/Detroit News article on a year-end report released by the Department of Health and Human Services' inspector general.
HHS Inspector General June Gibbs Brown said "beefed-up criminal and civil investigations of Medicare fraud and abuse made possible by laws Congress passed in 1996" produced an "unprecedented" $1.2 billion in recoveries.
The first-ever "comprehensive, statistically valid" analysis of the "fee-for-service claims that account for 90% of the $209 billion spent by the program" found that Medicare waste, fraud and abuse amounted to an estimated $23 billion last year.
One problem appears to be Medicare's lack of "the necessary resources to combat fraud, waste and abuse," according to testimony by the General Accounting Office's William Scanlon last week before a panel of House and Senate Democrats. (See "Dems Blast Medicare Fraud," Dec. 4.)
Scanlon said Medicare claims rose 70 percent to 822 million between 1989 and 1996, while the "resources to review those claims increased less than 11 percent." He said, "More individuals are being served but a lack of controls means unscrupulous providers can submit claims and get paid."
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