New cases show why Obama healthcare reform must tackle fraud

New cases involving Medicare fraud are a good example of what’s wrong with government funded healthcare. As President Barack Obama ramped up his strategy to reform or remake American healthcare—it’s not clear what the Democratic Congress is really trying to do—fraud in existing government programs continues on a grand scale. Medicare and Medicaid fraud aren’t topics for breathless anchors to explore on newscasts and magazine style programs. But the level of fraud costs both taxpayers and patients in the long run. Two cases in Florida and another in Houston are small examples of failure in overseeing entitlement programs that in the long run could bankrupt our country.

Yet few politicians ever bring the subject up unless a constituent asks about it in a townhall.

In Miami defendant Reinaldo Guerra pled guilty to one count of conspiracy to commit Medicare fraud and one count of Medicare fraud. An FBI release said the fraud involved durable medical equipment—walkers, wheelchairs and hospital beds are a few of the items classified as DME.

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Politicians, president and media aren’t talking about who can’t get health insurance

FBI director Robert Mueller announced a crackdown on healthcare fraud indictments against 53 people in a combined enforcement effort specifically targeting fraud schemes that threaten Medicare.Politicians and media pundits repeatedly claim 45 million “Americans” can’t get health insurance, prompting me to research the makeup of that constituency. I settled on data from the Employment Policies Institute in part because the organization had just released a study containing specifics about the types of individuals who don’t have insurance. I did compare figures to information at the National Coalition on Healthcare, a group claiming to be “rigorously nonpartisan.” Members include the AFL-CIO, the League of Women Voters, the NAACP, healthcare organizations and teachers’ unions.

A reader pointed out EPI is a lobby group. Who isn’t these days? In my opinion, the NCH has a lobbyist-like approach. Yet the figures from both organizations are comparable. However the EPI provided more descriptive specifics as detailed in my earlier column.

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Texas case another example of rampant Medicare fraud

(Dallas, Tex.)—Irene Anderson, 45, owner of a home health care agency in Wylie, Texas, has pled guilty to mail fraud. Anderson created a fictional identity in order to defraud Medicare. Anderson set up a second healthcare agency in Sulphur Springs, which garnered $1,188,698, under the fictional name “Ilya Edwards.”  She obtained a social security number and a Texas driver’s license for that name too, falsely representing herself.  The Dept. of Justice says the woman faces a maximum statutory sentence of 20 years in prison and a $250,000 fine. She has agreed to restitution of more than $2 million. This is one small example of rampant fraud in federal health programs. In states like Florida, state government officers are going after people who defraud Medicare.

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