Friday, July 15, 2011

Feds Miss Medicare Fraud

That's assuming they really meant to catch them.

"Health care fraud alert systems deemed faulty; Review finds technology disorganized" July 13, 2011|By Kelli Kennedy, Associated Press

MIAMI - The federal government’s systems for analyzing Medicare and Medicaid data for possible fraud are inadequate and underused, making it more difficult to detect the billions of dollars in fraudulent claims paid out each year, according to a report released yesterday. 

Related: There is Money in Medicare Fraud

National Health Care: Mossad Milking Medicare
  
Madoff Billions Are In Israel 

That's where all the money goes, huh?

The Government Accountability Office report said the systems do not even include Medicaid data. Furthermore, 639 analysts were supposed to have been trained to use the system, yet only 41 have been so far, it said.
 
And here I wanted a good, decent, single-payer system.

The Centers for Medicare and Medicaid Services - which administer the taxpayer-funded health care programs for the elderly, poor, and disabled - lacks plans to finish the systems projected to save $21 billion.  

What is that, about two months worth of war?  

And the HEALTH CARE is WHERE I WANT MY TAX MONEY GOING -- not for foreign aid in far-flung places of occupation for the empire!!!  

END the EMPIRE and SAVE the REPUBLIC!

The technology is crucial to making a dent in the $60 billion to $90 billion in fraudulent claims paid out each year.

“I’m looking forward to hearing, someday, about major fraud scams discovered as a direct result of this integrated repository and the use of creative pattern recognition techniques implemented on top of it,’’ said Malcolm Sparrow, a health care fraud expert at Harvard University. “Until we hear that story, the public is not getting value for money from these investments.’’  

We NEVER DO from GOVERNMENT!

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The new $150 million systems, which went live in 2009, are intended be a one-stop storage for all data, accessible by all CMS staff and its contractors, law enforcement, and state agencies.

But crucial pieces are still missing, including so-called “share systems data’’ that would help analysts identify and prevent payment of fraudulent claims, according to the report.

The agency planned to include this by 2008, but funding for the software to implement the system was delayed. CMS is now aiming for November, the report said....  

Have the wars been delayed?

Medicare is one of the largest payer systems in the world, with contractors processing about 4.5 million claims per workday. For decades, CMS has operated under a pay-and-chase system, paying the claims quickly so legitimate medical providers can operate and following up on suspicious claims afterward. 

Same thing they do with war contracts. 

But as Medicare fraud has morphed into sophisticated scams, access to data showing what claims are being paid in real time has become more critical. By the time officials process the scams, crooks have already fled with the money....

The war profiteers must have pioneered it.

On July 1, CMS implemented a new technology program, which is not included in the report....

Medicare has awarded an initial $77 million contract for that system....

Related: Defending Medicare

Somehow the newspaper left out who is running the program.

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