'60 Minutes': Medicare Fraud Raises 'Troubling Questions About Our Government's Ability to Manage a Medical Bureaucracy'

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"60 Minutes" did a fabulous exposé Sunday on Medicare fraud that should be required viewing for all people who support a government run healthcare program in this country.

The facts and figures presented by CBS's Steve Kroft were disturbing as were the details concerning how shysters bilk the system for an estimated $60 billion a year. 

As Kroft warned viewers in the segment's teaser, "We caution you that this story may raise your blood pressure, along with some troubling questions about our government's ability to manage a medical bureaucracy" (video embedded below the fold with partial transcript, h/t Marc Sheppard):

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STEVE KROFT, CBS: Of all the problems facing the United States right now, none are more important than healthcare. President Obama says rising costs are driving huge federal budget deficits that imperil our future, and that there is enough waste and fraud in the system to pay for health care reform if it was eliminated.

At the center of both issues is Medicare, the government insurance program that provides health care to 46 million elderly and disabled Americans. But it also provides a rich and steady income stream for criminals who are constantly finding new ways to steal a sizable chunk of the half a trillion dollars that are paid out each year in Medicare benefits.

In fact, Medicare fraud - estimated now to total about $60 billion a year - has become one of, if not the most profitable crimes in America.

We caution you that this story may raise your blood pressure, along with some troubling questions about our government's ability to manage a medical bureaucracy.

Kroft spoke with FBI special agent Brian Waterman and Kirk Ogrosky, a top justice department prosecutor:

BRIAN WATERMAN, FBI: There's a healthcare fraud industry where people do nothing but recruit patients, get patient lists, find doctors, look on the Internet, find different scams. There are entire groups and entire organizations of people that are dedicated to nothing but committing fraud, finding a better way to steal from Medicare

KROFT: Is the Medicare fraud business bigger than the drug business in Miami now?

KIRK OGROSKY, JUSTICE DEPARTMENT: I think it's way bigger.

KROFT: What changed?

OGROSKY: The criminals changed...

WATERMAN: Sophistication.

OGROSKY: They've figured out that rather than stealing $100,000 or $200,000, they can steal $100 million. We have seen cases in the last six, eight months that involve a couple of guys that if they weren't stealing from Medicare might be stealing your car.

WATERMAN: You know, we were the king of the drugs in the '80s. We're king of healthcare fraud in the '90s and the 2000's.

Kroft also spoke to Attorney General Eric Holder:

ERIC HOLDER, ATTORNEY GENERAL: We have to understand this is a major fraud area. [...]

KROFT: Why do you think it's been so attractive for the criminals?

HOLDER: Because I think it's been pretty easy. I think that they have found a way in which they have been able to get pretty substantial amounts of money with not a huge amount of effort and at least until now, without the possibility of great detection.

KROFT: With much fewer risks.

HOLDER: Much fewer risks. You'll see some of these people and they'll say "You know there is not a chance that you are going to have some other drug dealer shooting at you." The chances of being incarcerated were lower, the amount of time that you would spend in jail was smaller. All of which is different now.

Kroft then spoke to a man who claimed to have defrauded Medicare out of $20 million, after which Kroft said, "According to the FBI, all you have to do to get into this business is rent a cheap storefront office, find or create a front man to get an occupational license, bribe a doctor or forge a prescription pad, and obtain the names and ID numbers of legitimate Medicare patients you can bill the phony charges to."

WATERMAN: There's a whole industry of people out there that do nothing but provide patients.

Kroft narrated, "Once the crooked companies get hold of the patient lists, usually stolen from doctors' offices or hospitals, they begin running up all sorts of outlandish charges and submit them to Medicare for payment, knowing full well that the agency is required by law to pay the claims within 15 to 30 days, and that it has only enough auditors to check a tiny fraction of the charges to see if they are legitimate."

Later, Kroft asked Waterman, "There's something I don't understand. I mean, you're saying essentially people just fill out the phony paperwork, they send a bill to Medicare and they pay it."

WATERMAN: That's why you have companies that can run for 60, 90 days, and bill for ridiculous things. Because there are very few checks and balances to even determine whether these things a, were medically necessary, b, were ever given, or c, even physically possible for a patient with the kind of conditions they have.

A bit later in the segment, Kroft spoke with Kim Brandt, Medicare's director of program integrity. After he shared with her some of the scams he'd previously witnessed or been told about, he asked how crooks get away with it:

KIM BRANDT, MEDICARE DIRECTOR: We're as frustrated by that as the law enforcement officials that you went out with. And in fact, our primary focus over the past years has been to tighten our enrollment standards to make it so it's much harder for people like that to be able to get in the program, and to be able to commit that kind of fraud.

KROFT: Look, I'm sure that you're aware of these problems. But it doesn't seem like you're doing a very good job. I don't mean you personally, but I mean, the government. This is still like a huge problem, and getting worse, right?

BRANDT: Well, it really does come down to the size and scope of the Medicare program, and the resources that are dedicated to oversight and anti-fraud work. One of our biggest challenges has been that we have a program that pays out over a billion claims a year, over $430 billion, and our oversight budget has been extremely limited.

Just imagine what the fraud will be like if the government is responsible for everyone's healthcare.

As the segment drew to a close, Holder told Kroft something that should scare the heck out of everyone who wants government run insurance for all Americans: "I think people I don't think necessarily thought that something as well intentioned as Medicare and Medicaid would necessarily attract fraudsters. But I think we have to understand that it certainly has."

Yes we do.

Yet, shortly after this marvelous segment came to a close, "60 Minutes" concluded this installment with Andy Rooney telling viewers:

I'm not much interested in hearing anymore talk about health care.

President Obama wants to overhaul what they call the "health care industry." Well good, but I hate that phrase the "heath care Industry." I just don't like to think of my health as an industry.

The fact is though being sick is often the least of our health problem. Even if you're insured, what hospitals charge now is ridiculous. I had what they call "an outpatient procedure" recently and it cost my insurance company $9,361. I say it cost my insurance company but let's face it. In the end, I'm the one who pays.

The U.S. spends more than any other country on Earth on its health: $2.5 trillion. And what do we get for $2.5 trillion? Well, we're 50th in the world for life expectancy, below the Polynesian French Island Territory of Wallis and Futuna, wherever Wallis and Futuna are.

As Steve Kroft said earlier on 60 Minutes, we are losing billions of dollars on health care fraud. Not on healthcare - on healthcare fraud.

Everyone cheats - companies, hospitals, patients, doctors, drug companies, and government agencies. Cheating goes on everywhere in the get well business.

During my recent outpatient procedure a doctor came into my room, asked how I was doing and said, "By the way I love your work on television." He left without touching me and a couple of weeks later when the bill came, it turned out his visit cost my insurance company $250.00.

I mean who knows what he would have charged if he didn't like my work.

There's just no doubt we need healthcare reform because the way it is now, makes me sick.

Makes you wonder if he even watched Kroft's segment, doesn't it? 

—Noel Sheppard is the Associate Editor of NewsBusters. Follow him at Facebook and Twitter.


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Doctors--don't treat celebrities. Let them die.

What a cheap shot from Rooney, an implication that his doctor is dishonest without any context.  And the doctor can't even defend himself because of HIPAA.

 

 

What's Rooney talking about?

What's Rooney talking about? "His health insurance company?" He's been living off of the taxpayers for ions now even though he is a multi-millionaire! What a liar!

Corruption aside

I am sure that no average bureaucrat anywhere can understand the myriad rules, regulations, lawspeak, medical speak much less monitor all the possible loopholes where corruption, theft, bureaucratic stupidity and apathy all meet in one gigantic confusing mess concerning medicare. Think of the 1000 plus pages of the current health bill and then add the myriad addendums, subtractions, incentives, disincentives, and mind numbing/boggling verbiage trying to explain it all. Somebody somewhere will have to read read all 1000 pages and the rest to make any sense of it and then figure out how to catch the conmen et al including those who are just confused. Somebody really smart out there will figure out how to milk the system without a scintillas chance of being caught.  

"Somehow, I told you so, just doesn't quite say it." Will Smith in 'I, Robot.'

"60 Minutes" Is Not A "Real" News Show

And Steve Kroft is a racist lunatic who is inciting mobs of angry teabaggers. /snark

government managing healthcare

Gee Golly Gee whiz! Who'd a thunk a thing like 60 minutes presented?

Rather than fixing the broken bike, our house and senate are going to rush out and buy us all another more expensive broken bike.

 

Gee thanks!

 

I think it is time Obey and Kohl go out and find a job. Feingold probably too. I don't care who runs against those three. A drooling, blathering idiot will still be better.

That's where the money is

It's the Willie Sutton rule: why do you rob banks? That's where the money is. That much money attracts thieves. Healthcare is going to be another trillion-dollar government program, on top of the trillion-dollar debacles we have now. 

You won't even have to be a clever thief to make money in that racket. 

Yeah....

I am SO sick of hearing this life expectancy stat being compared to how much is spent on health care. Look, if people are running around doing things that are bad for their body constantly, they're going to die sooner! Life expectancy doesn't automatically mean that our system is crappy and making people DIE FASTER. It's such a stupid ploy the left is using, and people just go, "ooooh, aaaaah, numbers! They must go hand-in-hand!"

I cannot stand these morons.

From Statistics 101:

From Statistics 101: Correlation does not imply causation. 

"A communist is someone who reads Marx.  An anti-communist is someone who understands Marx."  Ronald Reagan

Ins vs gov

Darn another lost opportunity to get rich! I missed the whole Drug Frenzy and now I missed the Medicare Fraud. Sure I didn't go to jail but feel like a total L7 missing this new opportunity!

If you think medical care is expensive now wait until it is free!

Now hold on just a second...

You mean to tell me that the U.S. Government has a history of wasting money and running things in an inefficient manner? I'm really pissed that no one mentioned this to me before!

http://blixamerica.b...

Maybe you can.....

Maybe you can ride the upcoming wave of Medical Maijuana.  That should be profitable and interesting. LOL

Crank up the Bus

Will CBS be thrown under the bus with FOX over this? 

President Obama says rising

President Obama says rising costs are driving huge federal budget
deficits that imperil our future, and that there is enough waste and
fraud in the system to pay for health care reform if it was eliminated.

Oh, yeah, right.  They are going to eliminate the "fraud, waste, and abuse."

They are. 

Seriously. 

This time they're going to do it. 

No, really. 

 

Mom, of course they are. 

Mom, of course they are.  Haven't you been paying attention?  Marxism/socialism will work in America because we are so much smarter than the Russian communists, or the Chinese communists, or the North Korean communists, or the Cuban communists.  America now has Obama!  Obama, Obama, Obamassiah!  He can walk on water!  He will run America's energy needs on unicorn farts and rainbows!  Compared to Obama, Jesus was an amateur: Obama will feed the entire world on the same number of loaves and fishes that Jesus fed a few thousand...and there will be no transfats and no artificial sweetners in the meal.  Pay no attention that he can't get the Olympics for Chicago, hasn't reduced America's carbon output (even though, America is a net carbon sink), hasn't stabilized either world temperatures or climates, hasn't reduced America's dependence on foreign oil, hasn't healed the sick or lame or blind.  No, no, if you observe what he has accomplished (or, rather, what he hasn't accomplished) why, you are a racist. 

"A communist is someone who reads Marx.  An anti-communist is someone who understands Marx."  Ronald Reagan

LOL!

Right on, MB. And with all the loose change lying in the streets, we could finance TARP. Right. 

Sure I believe it. I have complete faith in the Democrats and the Obama Administration. (By the way, how much is a one-way plane ticket out of here before the disaster? I ask merely for information.) 

STEVE KROFT, CBS: Of all

STEVE KROFT, CBS: Of all the problems facing the United States right now, none are more important than healthcare.

Really? 10-20% unemployment seems to be a more important problem in my mind. If you have no income who wants to spend money on doctors visits, prescriptions or hospital stays? You can't buy food, gas, a home, heat, electricity with health insurance.

D

Write your Congress and Senate and tell them what YOU think!

Keep the ILLEGALS out, join NumbersUSA to send free faxes to your reps.

I agree--unemployment far, far worse

Out here everyone is paying for electricity with prepaid cards, and going to the food bank. No one can sell their houses. My kid has been out of work for 6 mos. I work for myself, but some rich brainiacs over at web content mills have decided writing is worth squat or else that writers are such boobs they will take squat. So gee.... But this is the mantra--this kloodged-up horror of whatever involving health is just what we need! You know what--this admin reminds me of the boyfriend who makes you laugh--you stick with until you realize that every time they make you laugh, they made you cry first.

Corrupt in it's entirety

Every single aspect of every government everywhere must be assumed to be corrupt until proven otherwise.  It starts with the local zoning board controlling where tax payer projects and roads are built so that they can profit from land sales, and goes all the way up to the Federal Government.

Why is college so expensive?  Because the government doles out money to pay for college.  Why is healthcare so expensive?  Because our state and federal government is involved in the process.  Why did a three bedroom run of the mill house in California cost one million dollars at the peak of the "housing boom" in 2006?  (Hint:  It wasn't because of the "Free Market".)

Our government has become the biggest organized crime racket imagineable.  We cannot reform organized crime.  It must be eliminated and scaled back to provide only the essentials;  Infrastructure and Defense.  No more grants to study the effects of no naps on four year old children.  No more college loans to 25 year olds so they can learn to be "social workers".  No more tax credits to direct consumers to purchase the latest, favored segment of the depressed economy.

Power needs to go back to the states so people can decide how much government they want, locally.

Pelosi wants a robust public MANDATE

For millions of people it will be a PUBLIC MANDATE, not a public option.

Undeniable proof that

Undeniable proof that goverment is incompetent when it comes to healthcare.  Isn't this what critics of Obamacare have been saying for months now?  And 60 Minutes is just now catching on?

Can we expect 60 Minutes run a special on Van Jones next week? 

              

                 Way to keep up, 60 min.. We have known about the fraud for a long time. But the federal govt. is either too stupid to do anything about it, or they are in on it. I think they are in on it. It's like the illegals in this country. The govt. has known about it, but refuses to do anything about it. Makes me wonder how much money they are making on this fraud, amd other crimes against the people.                                                                                                                                                                                                                                          

Krugman's got the hot pants and pom-poms over at the NYT

He says "maybe" the admin is working against it's own professed love of a Public Option, but this is prob overblown, so THIS THING IS GOING TO WORK! Whupeee. Wonder what they pay this guy. He always comes off as such a shill.

 

Medicare Fraud

If you recall, the report from Steve Kroft started with a statement about the "rising cost" of health care.  IMO this sentence should not have even been included as a lead-in to the subject matter at hand. 

MSM, in their constant attempt to make a case for supporting Obama's health care initiative, takes every opportunity to drag issues that are not relevant to the health care debacle into their reporting, in order to help the Zero ram this flawed fix down our throats.  Granted, this massive fraud of Medicare is beyond comprehension and needs immediate attention, but correcting this problem does not require a complete overhaul of our health insurance system. 

Eric Holder even admitted that Florida has only three auditors to cover fraud investigations.  Well duh, if the solution to this $60 BILLION fraud is more enforcement personnel, then doesn't it make sense to HIRE MORE FRICKEN PEOPLE.  One thousand more auitors, @ $60,000 p/yr = $60,000,000!

Sixty million dollars is only .001% of sixty BILLION dollars, which seems like a no-brainer way to gain control of this bleed.  Of course, this solution would be way to difficult for government to figure out.  Just another reason to keep government out of almost all of this nations programs, other than defense.

Second issue, and I carefully tread into this subject, least I appear as a complete "Right Wing Nut Job."

Katty Couric had a heart felt, sad report about people with seisure disabilitiies on 60 Minutes last night.  It was disturbing to watch the anguish that these poor folks endured, as well as the family trauma that went along with this malady.  Anyone with a heart could not feel anything but sadness for them and their family.  It is with these feelings that most caring people would want to support these families in any way they could.  I am sure that there are thousands of people that suffer from this desease.  Which leads me to this statement, keeping in mind what I previously said, that I might be seen as a RWNJ.

Knowing the constant mindset of the MSM, and their in the bag for Obama reporting, why did they find it necessary to use David Axelrod's daughter as the focus of this report, rather than any other non-descript parents that also have these same conditions affecting them every day? 

Why, (here I go, taking my dive) because Axelrod works for Obama, and Axelrod gets our sympathy from the story, and the subliminal effect of the sorrow also transcends to Obama, which makes one, not want to feel antipathy to him as well.  Tell me that wasn't thought of and discussed, when putting this story together.

 Call me crazy, but I'm just saying...............

 

At the tea party protest i

At the tea party protest i see a lot of older americans 65 and older saying stop socialism, stop gov't take over of medicine. 

my response is great, but what the he-ll do you have? socialized medicine. I'm glad you're against socialized medicine for me, but give me back all my money that goes to paying your extravagant health care coverage and all your awesome drugs thats bush said should be covered by young americans paying taxes in medicare part D.  

Um....

People getting this "socialized" medicine paid into it for 40 yrs, sometimes more--"mandated" to pay as they say now. And even then, it's going broke because the money was not used for Medicare--it was just spent. They also still pay--do you think Medicare is free? It is less than insurance in the private market, but it's not free, despite all those payments. And you will be fined if you don't pay into a drug plan you don't need--if you decide to get it later. That would be a "mandated" deal once again.

Sajc05 just got schooled.

Knowledge is power.  My guess is that Sajc05 has never even bothered to look at a pay stub and wonder just what all those deductions were all about.  Or maybe he never has had a job?

Sajc05

05 wants freeeeeeeeeeeeeeee health care. You are probably correct. Lives in section 8 housing, receives food stamps and only leaves the house to cash his welfare check. 

Wow, good to see 60 Minutes

Wow, good to see 60 Minutes is really up on things and has our six!

What a disgrace.

One of the 34% who thinks George W. Bush was a great President. One of the 86% who wants to bring back the stock and pillory.

So if I understand Mickey Rooney right...

He wants to solve the problem of Health Care fraud by increasing the size of  Health Care fraud? 

"The bureaucracy is growing to meet the needs of the growing bureaucracy"