Policy

Medicare Fraud: Big League Faking It

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How much more common would this problem be under a universal healthcare system?

Rita Campos Ramirez orchestrated what prosecutors call the largest health-care fraud by one person. Over nearly four years, she electronically submitted more than 140,000 Medicare claims for unnecessary equipment and services. She used the proceeds to finance big-ticket purchases, including two condominiums and a Mercedes-Benz….

Employees review fewer than 5 percent of the nearly 1 billion claims filed each year. The vast majority of claims shuttle through computer systems that are tweaked when authorities notice fraud patterns.

And how do the Medicare and Medicaid authorities respond to these crooks?

This year, [Centers for Medicare & Medicaid Services] is working to finalize a rule that would prevent convicted felons from obtaining Medicare billing numbers.

Looks like even a universal program would leave a few people high and dry.

Senior Editor Jacob Sullum with more Medicare madness. Senior Editor Radley Balko on Medicaid Fraud and the 4th Amendment.