One form of Medicare fraud occurs when a doctor or provider of medical supplies seeks reimbursement from Medicare for medical services or equipment that was never provided or for an amount greater than the service or equipment was worth. When the system works, a doctor or medical supply company will provide a service or piece of medical equipment to a patient covered by Medicare and then submit a proper reimbursement form to Medicare for payment. However, because of the bureaucratic and wasteful nature of the Medicare program, this system is wrought with fraud.
There were approximately $93 million in fraudulent Medicare claims in the United States from 2000 to 2007, according to a recent congressional study which was reported at Sfgate.com. The study found that millions of dollars were being paid to medical supply companies via reimbursement forms based on prescriptions that were over ten years old and/or that were from dead doctors. Florida, which has a high number of Medicare claims due to the age of its population, had more than $2 million in Medicare claims paid to medical supply companies based on prescriptions from 114 dead doctors; over $500,000 was paid for prescriptions from a single doctor who died in 1999.
An amazing 27% of dead doctors in Florida still had an active Medicare ID number that could be used to seek payment through Medicare.
Medicare officials claimed they have been working to correct this expensive problem. For starters, they are trying to update their records as to whether a doctor with a Medicare ID is dead or alive every 90 days as opposed to every 15 months or more. They also plan more regular audits of those making Medicare claims to make sure the Medicare claims are consistent with the services and supplies actually provided.