From Merrill Matthews, writing for The Hill:
The point is that if the federal government were better at preventing Medicare and Medicaid fraud, the programs could save perhaps $100 billion a year or more. While that wouldn’t solve Medicare’s long-term financial challenges, it would certainly help delay the day of reckoning.
While no one defends the fraud, many politicians and bureaucrats don’t seem that interested in trying to fix it. Indeed, when Republican state legislators propose verifying state Medicaid rolls to ensure recipients are qualified, Democrats usually push back.
What’s clear is that there is a way to cut Medicare without hurting Medicare patients, and that’s to cut the fraud. But it’s much less work, and perhaps more politically rewarding, to just attack political opponents.
Most people would agree that Medicare fraud should be stopped, but that’s easier said than done. Medicare’s Prospective Payment System (PPS) is part of the problem. They pay first and ask questions later. By that time, the money is long gone.
The federal waste, fraud, and abuse laws are also complicated. Many well-meaning providers do not understand them. There is growing support for revamping the Anti-Kickback Statute.