Article 93. Example of Massive Medicare Fraud

 Example of Massive Medicare Fraud

Hospitals throughout the US in a large numbers are using sick and confused mostly elderly patients as cash cows billing Medicare for unnecessary treatments. This mass fraud is used to finance hospital operations and building projects.

Example of how the Fraud works:
An elderly person without a private Doctor seeks healthcare through the hospitals walk-in clinic.  The clinic gives convincing advice suggesting the patient needs blood tests and suggests that a hospital doctor becomes the patient’s private doctor.  Once the patient selects a private doctor connected to the hospital the Doctor arranges for extensive blood tests and other related tests including X-rays and other expensive observations.  The hospital can run-up thousands of dollars of unnecessary tests and exploratory operations all billed to Medicare.  This is not an isolated case but common practice.  At present there is no mechanism for preventing this type of fraud.  The cost of prosecuting those committing this type of fraud is in most cases greater than the cost of the fraud itself.

The Solution:
Require all Medicaid patients to have a private doctor.  This Doctor must be certified to be an independent doctor not connected to a clinic or a hospital in any way and subject to verification by Medicare.  The private doctor will independently determine what tests and exploratory operations are required for the patients healthcare.

This suggested solution can save $billions in unnecessary Medicare expenses.