Who Will Audit the Auditors?

Jacob Sullum | August 22, 2008

The inspector general, that's who. In an upcoming report, "a draft of which was obtained by The New York Times" (a copy of which was discovered by me in my driveway yesterday), the inspector general for the Department of Health and Human Services discredits recent boasts that the government is finally cracking down on Medicare fraud. According to the report, auditors working for AdvanceMed, a company hired by Medicare to examine medical equipment claims, found only a fraction of the fraud because Medicare officials told them not to look too hard. The auditors were instructed to "examine only the documents submitted by the companies selling the medical equipment, rather than verify those documents against physicians' records." Since a common scam is to charge Medicare for equipment that was never recommended by a doctor (some of which is delivered but never actually used), this circumspection allowed a substantial amount of phony billing to slip through:

Medicare reported to Congress that, for the fiscal year of 2006, AdvanceMed's investigations had found that only 7.5 percent of claims paid by Medicare were not supported by appropriate documentation. But the inspector general's review indicated that the actual error rate was closer to 31.5 percent.

Comments

Nigel Watt|8.22.08 @ 11:43AM|#

...31.5%? Jesus Christ.

|8.22.08 @ 11:44AM|#

The inspector general, that's who.

You forgot the link.

|8.22.08 @ 11:47AM|#

I have to quit my real job and go into scamming the government. What was I thinking when I decided to work honestly?

|8.22.08 @ 11:50AM|#

The inspector general, that's who.

Hey, Plato: Ha ha, you suck! Mr. Smart Guy, huh? Betcha didn't see that coming, didja?

Junter Klops|8.22.08 @ 11:52AM|#

Stop lying Epi. Everyone knows you don't have a real job.

|8.22.08 @ 12:01PM|#

only 7.5 percent of claims paid by Medicare were not supported by appropriate documentation.

If a mere 7.5 per cent of your business expense deductions were not supported by documentation, would the IRS pat you on the back and tell you, "Great job, Buddy!"?

That's what I thought.

|8.22.08 @ 12:05PM|#

and that's just the fraud for equipment. the fraud for services, exams and the like, has got to be out of control. they say the govt medical system is better because it cuts out the overhead expenses. oh, you mean like the overhead that examines the claims to root out fraud? medicare just shovels money out the door, then they get to pat themselves on the back about how many old people got medical treatment this year, when $60B of those claims were fraud. Can't wait 'til everyone is in the same system.

|8.22.08 @ 12:17PM|#

Stop lying Epi. Everyone knows you don't have a real job.

Oh, it's real. However, I am not.

|8.22.08 @ 12:18PM|#

So you're saying that you want children without insurance to die? Is that what you're all saying? Children with cancer?

|8.22.08 @ 12:20PM|#

Wow. I thought 7.5% was a big enough number to be upset about. But 31.5%? Eveb if we split the difference and say 20% (like scott indicates, only for equipment), then Holy ****!

|8.22.08 @ 12:22PM|#

Big deal. Nobody pays for free health care. Everybody knows that.

|8.22.08 @ 12:24PM|#

apparently i just want over 65 year olds to die.

Bingo|8.22.08 @ 12:24PM|#

Why do you hate children and retired people?

|8.22.08 @ 12:26PM|#

How many fraudulent claims do you think get through, say, pacificare? I'm willing to bet it's very close to zero.

|8.22.08 @ 12:38PM|#

You guys, you guys, five years from now when we're all on Obamacare, there will be strong disincentives against defrauding the system.

Communal concern and patriotism.

Elemenope|8.22.08 @ 12:43PM|#

31.5% is close enough for government work.

Current Health Articles |8.22.08 @ 1:10PM|#

According to the report, auditors working for AdvanceMed, a company hired by Medicare to examine medical equipment claims, found only a fraction of the fraud because Medicare officials told them not to look too hard. The auditors were instructed to "examine only the documents submitted by the companies selling the medical equipment, rather than verify those documents against physicians' records.

Naga Sadow|8.22.08 @ 1:17PM|#

31.5 percent? Sweet Jesus! I'm gonna use this article to beat down my hick co-worker who is convinced that government healthcare is great. Assuming she can read. Assuming she will care about facts. Assuming she isn't an ignorant backwoods yokel who is convinced of her own superiority . . . aaaawwwwwwwwww, screw it.

|8.22.08 @ 1:27PM|#

doom
Dooom
DOOOOM

Naga Sadow|8.22.08 @ 1:43PM|#

Thank you Warren. I feel better now. It's when your doom comments don't appear that I get worried.

T|8.22.08 @ 2:41PM|#

doom
Dooom
DOOOOM

No gloom? No rumours of the boom? Pah. I want none of your cheap scaremongering. I want quality scaremongering, dammit!

And some of that 31.5%. Man, I wish I could get by with my work being only 2/3 accurate. Of course, then the things I design would either not work or fail catastrophically.