Statistics Of Medicaid Fraud That Will Shock You

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Statistics of Medicaid Fraud That Will Shock You

1. In May of 2014, some 107 healthcare providers including doctors and nurses were arrested in several cities. These ones were charged with cheating the programs out of some $452 million in funds.
2. In 2010 federal officials arrested some 94 people who had filed false claims through Medicare and Medicaid, for a total of $251 million in fraudulent claims.
3. The Medicare Fraud Strike Force was formed by federal officials in 2007. The group visited some 1600 businesses in Miami at random, following up on billing to Medicare for durable medical equipment. Of those businesses, nearly one-third did not exist although they had billed Medicare for $237 million in the past year.
4. It was reported
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This is the practice of routinely paying out every claim as it comes in and then only pursuing those that seem blatantly fraudulent, such as a dentist filing 991 claims in one day.
13. The Department’s Secretary Kathleen Sebelius has stated that they are planning on pursuing pre-claim adjudication to analyze patterns in claims before they are paid out, and are looking to abandon the “pay and chase” model within the next few years.
14. Some estimate that private insurers lose 1% to 1.5% of their revenue to fraud alone and credit card fraud is estimated to be at around 0.05%, while Medicaid and Medicare numbers are closer to 10% to 15%. One reason for this discrepancy is that private insurers and businesses like credit card providers may be more willing to invest in software and other technology that allows them to spot fraud much more quickly than government programs, and to do so before those claims and charges are paid.
15. Spending for healthcare is estimated to reach some $3 trillion in the U.S. in 2014 alone, although this amount does not currently keep up with the rate of inflation.
16. Claims pursued by the federal government in 2012 included unlawful pricing by drug manufacturers, illegal marketing of products and medical devices that have not been approved of by the Food and Drug Administration, and violations of law in regards to kickbacks and self-referrals.
17. The year 2012

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