Thread: Report: Medicare Paid for Inmate, Illegal Immigrant Health Services

Posted: Thu 3:58 PM, Jan 24, 2013
Associated Press

MIAMI (AP) -- Two new reports show that the taxpayer-funded Medicare program paid more than $120 million from 2009 to 2011 in violation of federal law for medical services for inmates and illegal immigrants.

Under federal law, Medicare generally doesn't pay for services for inmates or illegal immigrants. But the reports issued Thursday by federal health inspectors say Medicare was billed for more than $33 million in inmate care and more than $91 million for illegal immigrant care over that period.

The Department of Health and Human Services inspector general recommends that officials establish a better system to automatically flag and deny charges for both groups of patients.

Federal health officials say they plan to implement changes in April.

Report: Medicare Paid for Inmate, Illegal Immigrant Health Services

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http://www.alipac.us/content/report-...services-1303/

By Douglas Ernst
The Washington Times
Friday, January 25, 2013

President Obama told the Congressional Hispanic Caucus on Friday that immigration reform would be one of his top priorities. His comments coincide with a new report by Health and Human Services, which concludes that illegal immigrants and prison inmates have received more than $120 million in Medicare services from 2009-2011, even though they are ineligible for the program.

Nearly 3,000 illegal immigrants made $91.6 million in fraudulent claims for Medicare services over the report’s three-year duration.

The Centers for Medicare & Medicaid Services and the Office of the Inspector General indicated that retrieving the money might not be feasible. The report reads: “[CMS] is committed to recovering overpayments … but it must take into account the cost benefit of recoupment activities, including potential appeal costs and the cost of manually reopening these claims.”

Medicare improperly paid $120M to illegal immigrants, inmates - Washington Times

January 25, 2013
Rick Moran
The American Thinker

But don't you dare mention the word "reform":

Illegal immigrants and prison inmates received more than $120 million in Medicare services from 2009-2011 despite federal law that makes them ineligible for the program, according to two new reports from the HHS inspector general.

The issue, according to the reports, is timing. When Medicare is alerted that someone is incarcerated or undocumented, its contractors help prevent payments from going out the door. But often, Medicare's databases aren't up to date, and improper payments go out.

And Medicare lacks the tools to get the money back.

Nearly 3,000 illegal immigrants made thousands of claims resulting in $91.6 million in services improperly covered by Medicare during the three-year period studied in the report.

Over the same period, more than 135,000 Medicare beneficiaries were incarcerated, a second report shows. The report says that 11,600 inmates submitted more than 75,000 claims and received services worth $33.6 million.

"CMS did not have policies and procedures to review incarceration information on a post-payment basis that would have detected improper payments that the prepayment edit could not prevent," according to the report.

In responses to the reports, CMS agreed to identify improper payments and find ways to try to get the money back in the future, but the agency stopped short of pledging to go after the money already improperly out the door.

Estimates on Medicare fraud are iffy. That's because the government has no way to measure it. One ballpark estimate is 3% of total Medicare expenditures - about $68 billion. But some experts scoff at that number as ridiculously low.

One thing is certain: Medicare is a ludicrously easy target for con men and thieves since so much of it is automated and inadequate procedures are in place to verify eligibility. Not only that, Medicare has no tools to go after the money even when they realize the fraud.

They've been trying to deal with Medicare fraud since the 1970's and have failed utterly. Time to use some hi tech tools to protect the taxpayer from the criminals who seek to defraud us, as well as a government too lazy to protect us.

Blog: Medicare bilked of $120 million by illegals, felons