Turning Up the Heat on Fraud

By John Ballard

By way of illustrating journalistic negligence as described in the preceding post, I'm putting up this rather dry post to underscore something important which is not new, sexy or controversial enough to make headlines. The White House blog tirelessly grinds out stuff like this all the time, but it is doubtful that talking heads and demonstrators featured on TV spots pay much attention.

This appeared Thursday.

A new report released today (71 pages pdf) by the Attorney General and I shows that our fraud-fighting efforts are working � in FY 2009 anti-fraud efforts put $2.51 billion back in the Medicare Trust Fund, a $569 million, or 29 percent, increase over FY 2008, and over $441 million in federal Medicaid money was returned to the Treasury, a 28 percent increase from FY 2008.

But criminals aren�t quitting yet. In just the past few weeks, in states from Delaware to Wyoming, we�re hearing unfortunate examples of schemers promising medical benefits to seniors in exchange for their personal information. These schemes are not only a threat to taxpayer dollars, but are potentially devastating to seniors seeking care.

That is why we�re turning up the heat on scam artists who try to defraud taxpayers and exploit consumers. The Affordable Care Act will improve our ability to detect, track and prevent fraud, through enhanced communication and transparency across agencies and geographic regions, and stronger penalties for criminals.

Over the next 10 years, we�ll be investing $600 million towards these detection and enforcement efforts � investments that studies have shown pay for themselves many times over. And we�ll be working to empower Americans to help us fight fraud by building strong coalitions on the state and local level with law enforcement and seniors groups to educate people about their rights and to enlist them to become fraud fighters too.

Like all good politicians the language is calibrated to credit new people on task, suggesting that the Affordable Care Act is somehow triggering an outbreak of new fraud. But the stinking reality is that fraud and abuse has been so much a part of the past that most of what is now being harvested is low-hanging fruit. Just look at the percentages: twenty-eight and twenty-nine percent increases are huge.

If this is what's happening in the first year, before the rest of the money is allocated, imagine what can happen a few years out. These are the "savings" much discussed but overlooked during arguments before final passage that almost sank the boat.

Six hundred million dollars is a lot of money, but it's peanuts measured against the return on fraudulent billing and other criminal schemes. Here is the You Tube link to the press conference. It's as dry as they come, but drag the time tab to 18 minutes to hear Sebelius describe a variety of fraudulent activities that have been intercepted such as the sale of fake Obama-care policies, policies that protect seniors from death panels, or full health insurance for $29.95 which included dental coverage!

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The bigger picture is that reports like this are bubbling up every day but the press, both print and broadcast, no longer has the time or resources to get them before the very people who need to know, voters who elect officials in charge and pay taxes which supply the revenue stream making the reports possible. With all the yelling about accountability, it would be refreshing to hear complaints about the accountability of the media, demanding more content and less editorializing.