If you have anything constructive to add regarding how to combat fraud, I am all ears. But if (as it seems) you would just prefer to throw rocks, I am done with this conversation.

I had a buddy who worked on an Air Force based and was in charge of the fiscal year budget. The stuff about how that worked was enlightening to say the least. “Basically, we meet last year’s budget and tack on 5%. If we ask for less, we may never get more. So, we always use this +5% formula and back into it.”

The fact that claims are paid first is no excuse for paying $60 billion of fraudulent claims. Lots of entities are required to make prompt payments to service providers. That doesn’t mean they get bilked out of millions every day. Go ahead and make a fake bill for medical equipment and send it over to Northside Hospital, see if they pay it. Now do the same for Medicare . . .

But hey, $60 billion for services that were never provided isn’t “waste,” right? Taxpayer dollars well spent?

The REASON (as your article states) that Medicare fraud is easy to commit is that the agency must pay out most claims FIRST and then fight to get the money back later. HHS does this because if it intensively screened every Medicare claim before sending payment, then providers would have to wait a very very long time before getting paid. The article you cite suggests changing that system of paying claims first. It does NOT say that the U.S. is not working hard to stop fraud.

Gee whiz. If you’re going to cite an article, it should at least support your argument.

If you are interested in some accurate information about the United States’ efforts to stop Medicare fraud, here is a good link:
http://www.stopmedicarefraud.gov/heattaskforce/index.html
•Florida – March 13, 2012 – Miami-Area Resident Pleads Guilty to Participating in $200 Million Medicare Fraud Scheme – Read More
•Florida – March 9, 2012 – Area Halfway House Owner Sentenced to 24 Months in Prison for Participating in Fraud and Kickback Scheme – Read More
•Texas – March 9, 2012 – Owner of Houston Health Care Company Sentenced to 30 Months in Prison in Connection with Medicare Fraud Scheme – Read More
•Texas – February 28, 2012 – Dallas Doctor Arrested for Alleged Role in Nearly $375 Million Health Care Fraud Scheme – Read More
•Texas – February 8, 2012 – Assistant Administrator of Houston Hospital Indicted for Alleged Role in $116 Million Medicare Fraud Scheme – Read More
•Louisiana – February 6, 2012 – Louisiana Patient Recruiter Pleads Guilty in Health Care Fraud Scheme – Read More
•Louisiana – February 3, 2012 – Louisiana Medical Equipment Company Owner Pleads Guilty in $21 Million Fraud Scheme – Read More
•Michigan – February 2, 2012 – Rehabilitation Agency Owner in Detroit Found Guilty for Role in $2 Million Therapy Fraud Scheme – Read More

http://www.pbs.org/newshour/rundown/2011/03/medicare-fraud-is-incredibly-easy-congressional-panel-hears.html

So here you have an estimated $60 billion in complete waste in the course of HHS’ day-to-day operations. Just one example. There is waste and graft in contracting too, of course, but the waste is ubiquitous throughout a government that is simply too large and complex to oversee. Not that it’s getting any leadership from the top, as we are on year four of operating without a budget, in plain violation of federal law.