It’s a lucky thing that Obama’s Affordable Care Act finally gave Washington an excuse to stop losing money to health care entitlement fraud. Look for federal officials to go out of their way to prove to the public that they are delivering what the White House promised, even though they will never tell us why we need new bills and more spending to deal with old problems.
CMS fesses up to an old fraud problem.
Government media types do a stellar job of turning embarrassment into success. CMS closed the week boasting its efforts to combat Medicare home health care fraud thanks to Obamacare, confirming that there are “strong anti-fraud efforts already underway.”¹ They should be underway. We were warned about this kind of entitlement fraud decades ago.
A 1979 federal watchdog report called escalating home health care costs a “nationwide problem.”² The findings sounded suspiciously similar to what we just heard from CMS:
The Department of Health, Education, and Welfare (HEW) has been aware for years of the need to limit reimbursement for excessive home health costs, but just recently has it taken positive action.³
That was 34 years ago.
Entitlement fraud is good for promoting the health care act.
If you want to hear about government doing its job, just put a problem like the waste of tax dollars on the table. You will be amazed at all the safeguards we have in place, even as the problem gets worse.
Those responsible for implementing the health care act don’t seem to see a contradiction between telling us how much Obamacare is already doing while they delay implementation. CMS may have hopped on the cost savings bandwagon by stopping new home health care enrollments in troublesome cities, but what about the billions lost to bad payments, numbers that are still going up?
Another ugly fact about our health care entitlement problem.
CMS credits the Affordable Care Act with expanding its efforts to prevent and fight fraud, waste and abuse.4 The agency talks of $14.9 billion collected over four years.5 Meanwhile, federal improper payment numbers show that the percentage of bad payments is edging down while the dollars lost are going up. Medicare Advantage’s $15.4 billion in bad payments forecast for 2013 is up from 2012’s $13.1 billion, which was up from 2011’s $12.4 billion. The program has a 10.9% improper payment goal, a number that would only be good enough for government.6
Medicare Fee-for-Service is not looking so hot, either, doling out an expected $31.2 billion incorrectly for 2013 compared to 2012’s $29.6 billion and 2011’s $28.8 billion.7 How about Medicaid, Obama’s substitute for universal health care? The numbers are expected to be a little better this year, with only $17.4 billion paid improperly.8
Affordable health care grants? Hang on.
Want to watch health care fraud go through the roof? Hand out tax dollars and tell the beneficiaries the money should be spent on things like these Affordable Care Act grant suggestions:
prioritizing strategies to reduce racial and ethnic disparities, including social, economic, and geographic determinants of health;9
addressing special populations needs, including all age groups and individuals with disabilities, and individuals in both urban and rural areas.10
Give it time. In another thirty years we’ll still be trying to figure out how to get our money back.