Senior Citizen's Guide to Cleveland 2013 Vol. 1 - page 19
Billions of health care dollars are lost annually due to
fraud, error, and abuse. How many billions are lost in
the Medicare program alone? Since a certain amount of
fraud, error, and abuse go undetected, it is not possible
to know the exact figure. Though estimates vary widely,
the U.S. Government Accountability Office (GAO) esti-
mated that in FY2011, 42.9 billion dollars were lost in
the Medicare program alone. Many Medicare beneficia-
ries also receive Medicaid. The GAO estimated that 21.9
billion was lost to Medicaid in FY2011, for a combined
FY2011 loss to Medicare and Medicaid of 64.8 billion.
Health care fraud, error, and abuse threaten more than
taxpayer dollars. They threaten the health, financial in-
dependence, and security of Medicare beneficiaries, who
are primary targets. Even unintentional billing errors and
abuse result in excessive co-pays and deductibles. When
there is intentional fraud, however, these financial losses
are often compounded by medical identity theft, the re-
ceipt of inappropriate or detrimental health care services,
or even the loss of health care benefits.
Medicare fraud is big business for criminals,
but the government is getting tougher.
Historically, the penalties for Medicare fraud and the
risk of getting caught have been low, creating a tempta-
tion for even organized crime. “Building a Medicare fraud
scam is far safer than dealing in crack or dealing in sto-
len cars, and it’s far more lucrative,” Lewis Morris, Chief
Counsel at the Department of Health and Human Ser-
vices’ Inspector General’s Office, told the Orlando Senti-
nel. In response, the government has gotten tougher on
The Cost of Medicare Fraud,
Error and Abuse
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