Medicare Fraud, Essay Example

The woman could hardly believe her eyes, when she reviewed her mentally ill son’s Medicare Statement a few years ago. There were noticed charges for more than 70 respiratory treatments at a California doctor’s office, and she knew that didn’t need such treatments but had no way of reaching the doctor, so she called Medicare (FBI- Medicare Fraud, 2006).

After a period of approximately five years, the California doctor as well as the proprietor of the medical billing company were convicted according to FBI-Medicare (2006), of   illegally charging Medicare for over$7.6 million in unnecessary or unperformed treatments for the woman’s mentally ill son and many other mentally ill residents of California Board and Care Facilities (FB1- Medicare Fraud, 2006)

The case describes the essence of white collar crimes, which, according to the FBI, is lying, cheating and stealing and classified by the United States Justice Department as non – violent illegal activities involving deception, deceit, concealment, manipulation, breach of trust, subterfuge or illegal circumvention (FBI-Medicare, 2006), in the Medicare section of the Health Industry.

The President of United States in 2010, according to CBS News (2010), says the increasing costs that are driving massive federal budget deficits and endangering the lives of many are so astronomical, that if these fraud and wastes were removed, the cost of health care reforms would be adequately financed

The President was justified in making this statement, in that the lady in the case with her mentally ill son was just minor representation of 46 million victims being defrauded while seeking Medicare benefits, according to CBS NEWS (2006), and if one doctor and a medical billing service company can fraudulently extract $7.6 million over five years without detection, how much more thousands of white collar criminals combined are capable of stealing from the government.

FBI Agent Waterman, add to the  issue when he remark that the Medicare Fraud business is bigger than the drug business in Miami, and that this fraud health industry  criminals does nothing but record patients, acquire patients list, find doctors, search the internet, and find different scams  (CBS NEWS, 2006).

Medicare, according to CBS News (2006), has not only being providing benefits to the elderly and disabled, but also steady streams of incomes to white collar criminals to the tune of $60 billion annually.

The issue is therefore critically important, in that several of the 46 million residents in the country will suffer through lack of funds which has made its way in the pockets of criminals, and could have been spent elsewhere to boost economic development, especially from educational, employment and financial perspectives.

The volume of fraud  per year seems overwhelming for the limited resources of the FBI and the Justice Department, and should demand the infusion of alternative strategies to effect immediate reduction in the social disease that is contaminating the Medicare arm of the health industry at an extremely rapid rate.’

More public education is needed to help victims and would be victims like the lady with her mentally ill son and those with responsibility for the elderly to examine their financial statements and report every discrepancy observed, no matter how small, because they may be able to offset future million dollar fraud. The industry leaders should also implement more effective audit systems with a focus on medical facilities and billing system earning over one million dollars annually at the outset.

They should also impose very harsh criminal charges, similar to those done against drug offenders, due to the fact that the industry has exceeded it in terms of the amount of the fraud being committed.

Medicare Fraud will continue for years to come, unless the government treats the crime on the same level like the drug trade. The social disease is non-violent but it still destroys lives, deprives people of benefits, reduces industry and production efficiencies as well weakens the moral integrity of the nation gradually. The drug dealers prey upon the innocent, whom the cause to develop appetite for their products, while the white collar criminals uses modern technology  like the internet, to exploit the defenseless mentally ill and elderly in the nation.

Governmental interventions therefore, using the methods and strategies suggested as well as others innovatively developed, are urgently required to make significant dents in the threatening white collar crimes that have invaded the Medicare arm of the health industry.

Reference

FBI-Medicare Fraud (2006).Medicare Fraud-Don’t let this happen to you www.fbi.gov/news/stories/2006/march/medicare_032206 , 10/15/11

CBS News (2010).Medicare Fraud : A $60 Billion Crime www.CBSNEWS.com/stories/2009/10/23/60/minutes/main5414390.shtml , 10/15/11