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Medicare System Under Heavy Scrutiny, Criticism for Paying Suspect Claims

The Medicare system has been under heavy scrutiny before, but recent reports that Medicare paid out $47 billion in suspect claims leave many Medicare beneficiaries and participants wondering what’s in store for the future of the Medicare system. According to a federal report cited in an article today by the Associated Press, the U.S. government paid more than $47 billion in “questionable Medicare claims, including medical treatment showing little relation to a patient’s condition, wasting taxpayer dollars at a rate of nearly three times the previous year.”

The federal report indicates that there has been a dramatic increase in improper Medicare payments. The Medicare program is a $440 billion program that is considered by government auditors to be a high risk for fraud and waste.

According to officials, the increase in questionable claims may indicate that Medicare fraud is getting worse. However, a substantial portion of this increase may be attributed to a change in the methodology used by the Health and Human Services Department that requires stricter documentation requirements.

However, as the government looks to overhaul the healthcare system, a major emphasis has been put on cracking down on Medicare fraud. The federal report may indicate that the efforts implemented already to crack down on Medicare fraud are not working.

Examples of Medicare fraud include obtaining prescriptions from doctors who are dead and getting payment for medical supplies that are not purchased or even required.

Medicare beneficiaries may have a tougher time navigating through the Medicare system as a result of crack-downs, especially if they wish to obtain prescription medications or medical devices. Many Medicare participants may benefit by purchasing private Medicare Supplemental insurance to cover the cost of medical expenses that may not be covered by Original Medicare. Medicare Advantage programs may also be a viable alternative for Medicare beneficiaries who are worried about being able to actually take advantage of Medicare programs during the Medicare crack-down.

If you are interested in learning more about how a Medicare Advantage or Medicare Supplemental insurance plan can help to ensure that your medical expenses are covered, contact a Medigap Medicare Advantage specialist for more information today at 866-323-1441.

Wiley Long

Wiley Long

Wiley Long is founder and president of Medigap Advisors, and is passionate about helping people navigate the confusing waters of Medicare. He is the author of The Medicare Playbook: Designing Your Successful Health Coverage Strategy, a clear and simple explanation so you can make the most of your Medicare coverage. For more information visit www.MediGapAdvisors.com.
Wiley Long

 

 
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