On Friday, (July 22, 2016), the Department of Justice charged three individuals for conspiring to create a fraud scheme which billed more than $1 Billion to Medicare & Medicaid. One of the saddest parts of the story - "patients who were drug addicts were prescribed opioids - including OxyContin and Fentanyl to entice them to stay in the facilities." You can find more about the $1B case in this WSJ article.
This story made front page news this weekend, and rightfully so since $1B is a lot of taxpayer money! But, you know what is sad about this story? $1B is only 0.17% of the ~$600B spent each year on Medicare.
According to a Bank of America study (see Infographic below), Seniors (65+) spend an average of $3,450/month or ~$41,400/year.
So, what is 0.17% of $41,000? About $69/year. To put this in perspective, it would be as if you found out your landscaper overcharged an extra $5.75/month on your bill.
What should you do?
This math above is not intended to downplay the fraud that these alleged individuals committed. Actually, just the opposite - it's intended to bring perspective to the massive amount of money ($600B) this country spends on Medicare each year. We should all be scrutinizing the program to ensure it lasts for generations to come.
Example EOB Above. Here is a good article on how to read an EOB.
I hope the DOJ continues to pursue these cases and prosecute to the full extent allowed by law. More importantly, I hope fewer and fewer individuals attempt to scam our Medicare Program in the future.
See bio here