On Mon, 26 Oct 2009 18:17:34 -0400, John H.
wrote:



My brother, a retired cop, now works as an investigator of insurance
fraud for a health insurer. So I know that the civilian firms actually
do 'something' to prevent fraud. I don't think we have any idea of the
scope of the fraud going on with Medicare. As a Medicare recipient,
I'll say that it seems like it would be very easy to do.

Having worked for a major casualty insurer for years, I've been
beating the anti-fraud drum for years.
Even there I didn't feel enough was being done with anti-fraud
efforts.
Easier to deny the claims and raise the premiums of dumb honest
customers than to go after the smart crooks.
Hard to get a handle on what's really going on, except not enough
resources are devoted to fighting fraud.
Found this
http://www.cbsnews.com/stories/2009/...n5109783.shtml
And note this from it
"The fact that the suspects had to move to other states and other
avenues of Medicare - in this case, Medicare Advantage - signals an
understanding on the streets that officials are on to their old
tricks. And that the task forces are working, Sloman said.
Medicare Advantage allows the elderly and disabled to get benefits
through private health insurers. The plans receive a government
subsidy and generally offer more benefits than traditional Medicare."

Didn't see the 60 minutes piece so I don't know if they mentioned the
private insurance company role in it all.
But we need those kinds of exposes to get the folks ****ed off enough
to make the pols react.
But you watch all the squealing if the gov adds staff to fight fraud.
"Big government! Big Government!"

--Vic