The Impact Of Medicare Fraud On The Healthcare Industry

Medicare fraud isn’t just something that hurts a few people. In fact, it impacts the entire healthcare industry.

From wasting funds that could be going towards more medical staff to treat patients to people being denied life-saving procedures, this type of fraud is incredibly dangerous, and one that adds up to millions annually.

Medicare Fraud Facts

In 2018, government and law enforcement agencies participated in one of the largest fraud take downs in healthcare. The fraudulent schemes led to over $2 billion in Medicare and Medicaid losses. Over 600 defendants were charged. Medicare fraud is so prevalent that the US government actually saves $1.55 for each dollar invested in fighting fraud. Medicare Fraud Center gathered not only that statistic, but this alarming one as well – $92 million was paid out to deceased doctors between 2000 and 2007 in various fraud schemes.

The Deadly Side Of Medicare Fraud

The worst part is it’s not just lost funds. Instead, patients are dying as a result. Modern Healthcare dives into this deadly trend more in-depth, but a few highlights include:

· Patients treated by fraudulent practitioners were up 17% more likely to die

· In 2013, Medicare fraud led to at least 6,700 premature deaths

· Over 47,000 practitioners were banned from the Medicare and Medicaid programs in 2018, leaving many elderly patients without healthcare

While greedy organizations and practitioners were pocketing money, patients were suffering. From not having easy access to healthcare to not being treated properly, it’s the patients who get hurt the worst.

A Strike Force To Combat Fraud

Medicare fraud continues to impact the healthcare industry so much that Medicare Fraud Strike Force teams are now being created to combat the issue. These teams were first created 2007, but are still very much active today. In fact, you can check out all the latest take downs and court verdict results via the US Department of Health and Human Services. This list alone showcases just how prevalent this type of fraud truly is.

Other Major Consequences

Naturally, it’s not just patients who are affected. Healthcare professionals also suffer. Not only does fraud make patients highly suspicious of any medications, treatments or procedures, but it can also lead to people not seeking treatment when they need it. Legitimate healthcare workers may also end up fired when an organization is taken down for fraud.

Plus, higher fraud rates tax the entire healthcare, Medicare and insurance industries. This can lead to budget cuts at healthcare facilities, leading to fewer staff on hand to take care of patients. Overworked healthcare workers aren’t able to provide optimal care and often burn out early in their careers.

One final consequence is less coverage. In an effort to combat Medicare fraud, claims and necessary treatments may be denied. Since it’s hard to distinguish between fraud and legitimate needs, patients may be denied the treatment they need while others actually get treatments they don’t even need. It corrupts the entire system.

It’s vital for every patient and employee to report any suspicions of fraud immediately. This is the only way to combat fraud and ensure patients get the treatments they need.