The Medicare Bill

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The Medicare bill was signed into law on July 30, 1965 by President Johnson. The signage came long after an attempt by President Truman to develop a national insurance fund that could be utilized by all Americans. During the signing of the bill, President Johnson explained that with the Medicare program an individual can insure themselves against illness that may present during their senior years. Additionally, he commented that there were more than 18 million low income Americans who are greater than 65 years of age and cannot afford to treat their illnesses. The Medicare program is overseen by The Centers for Medicare and Medicaid Services (CMS), and has evolved over time. Medicare now covers individuals under the age of 65 who…show more content…
The goal of this deception is to obtain a federal healthcare payment that would not otherwise exist. The provider, practice, or institution may falsely claim to have provided a service or used supplies for a patient when in reality neither the service nor the supplies were used. A secondary way to commit Medicare fraud involves referrals. If one solicits, pays, or accepts money to encourage referrals because the services are reimbursed by Federal healthcare programs, they are participating in Medicare fraud. This type of fraud is addressed in the Anti-Kickback Statute. Lastly, Medicare fraud occurs when the complexity of services are overstated and billed at a higher than necessary rate. This action violates the False Claims Act which protects the government from being excessively charged for goods and services.
Medicare fraud is illegal and remedies are sought at both a civil and criminal level. If a provider, practice, or institution is found guilty of Medicare fraud, the consequences may include a loss of license, monetary penalties, and the inability to participate in Federal healthcare programs. The Office of Inspector General (OIG), which is a part of the U.S. Department of Health & Human Services, has the ability to exclude individuals who participate in Medicare fraud. The guilty party will be listed on a searchable database on the OIG website. The list is officially referred to as the List of
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