Medicaid Infested With Fraud


Last Updated: Thu, 10/01/2009 - 3:11pm

As the Obama Administration pushes for universal government-run healthcare a congressional audit reveals exorbitant fraud and abuse in the government’s decades-old insurance program for the poor, questioning the feds’ ability to handle a bigger plan that covers millions more.

During a two-year period alone, investigators from the Government Accountability Office (GAO) found 65,000 instances of fraud involving Medicaid’s prescription drug program in only a handful of states. The estimated cost to U.S. taxpayers is about $65 million but the best part is that state and federal officials failed miserably to prevent the outrageous scams.

Only five states (California, Illinois, New York, North Carolina and Texas) were probed so the crisis is thought to be much more widespread than documented in the GAO’s 18-page report. After all, Medicaid, which is jointly funded by states and the federal government, spends $23 billion on drugs for low-income patients each year.

In the probed states, about $2.3 million went to practitioners and pharmacies barred or excluded from federal health care programs, including Medicaid. Nearly 2,000 prescriptions were written for dead patients and 1,200 prescriptions were written by dead doctors. The most frequently abused prescription drugs were painkillers and mood-altering medications.

A detailed chart offers a breakdown of the various drugs that were fraudulently prescribed in the different states and how much Medicaid paid for them. The report also offers numerous anecdotes that illustrate the rampant corruption in the taxpayer-funded program that also covers anchor babies, the offspring illegal immigrants.

They include a man allowed by county officials in California to use the identity of a deceased person to get Medicaid benefits, a physician who prescribed expensive controlled substances to a dead woman, a Texas mother with a criminal history allowed to get various controlled stimulants in the name of her child and unqualified medical assistants writing prescriptions using dead physicians’ licenses.

In every case, investigators determined that the abuse should have been caught by negligent local, state or federal officials who instead missed the boat and allowed taxpayers to get cheated. This certainly indicates that the government cannot efficiently operate a much larger universal plan that affects the entire country.

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