Aiming to
Nab Medicare
Fraudsters L ike many Medicare recipients, Ed ward Davis of Miami re- views his quarterly statement for accuracy. Several years ago,
he was shocked to spot a $3,400 charge
for two artificial arms. “I checked my
arms and, yes, both were still there,” says
the retired federal judge. ; Davis, 76, is
one of thousands of victims of medical identity theft and Medicare billing fraud. “Not only did Medicare pay
[the bill], but also a bogus second one
for an expensive wheelchair,” he says.
; Now proposed federal legislation
may give prosecutors and law enforcement better tools to investigate, indict
and punish health care fraudsters. “Fraud perpetrated against both public and private health plans
costs between $72 [billion] and $220 billion annually,” said Sen. Ted Kaufman,
D-Del., cosponsor of the
Health Care Fraud Enforcement Act of 2009, in a statement. “We know rooting out
waste, fraud and abuse in
both government and private programs is critical to
making health care reform
work.” ; Whether it becomes stand-alone law or its provisions are incorporated into current health care reform proposals,
the bill would close a loophole allowing state-run
; Retired judge Edward Davis dis- covered a charge for artificial arms in his Medicare statement.
; The Poll
Internet Use
; Do you ever use
the Internet to …
Ages 50-64 65-plus
Research information
68 38%
Send and receive e-mail
or instant messages
64 41%
Buy a product
53 27%
institutions, including nursing homes, to obstruct
Department of Justice investigations into insurance plan fraud. And it makes it easier to expose
illegal kickbacks, such as when physicians
are paid to prescribe unnecessary drugs or
medical procedures, by making those losses covered by the False Claims Act. ; Davis, who notes with some irony that he often
presided over Medicare fraud cases, saw his
scammers prosecuted, but only after the local U. S. attorney’s office intervened. Still, the
fraud continues to dog him. After foot surgery
last year Davis needed a wheelchair. The response he received from a local medical supply
house? Sorry, you’ll have to pay for it yourself. You
already have one. —Laura Daily
Make travel reservations
50 25%
‘Fraud
perpetrated
against health
plans costs
between $72
[billion] and
$220 billion
annually.’
Work
46 14%
Do banking
43%
17 %
Read books,
newspapers, magazines
37 % 18%
