Spinning out of control

Friday, April 17, 2009 | 2:10 a.m.

Recent allegations of Medicare fraud against two local doctors led Las Vegas Sun reporter Marshall Allen to write about this crime from a national perspective.

What he reported in Wednesday’s paper is disturbing.

Annual claims filed with Medicare total more than $400 billion, but the annual budget for this government-run health insurance program for senior citizens and disabled people contains only about $120 million for investigating fraud.

Allen quoted Kimberly Brandt, director of program integrity for the Centers for Medicare and Medicaid Services. “There’s always going to be more fraud than the resources we have to meet it,” she said.

Allen pointed out that every dollar the government spends investigating Medicare fraud is more than returned through recovered taxpayer money. So why isn’t the fraud budget much bigger?

Brandt said that question is for “the administration and Congress” to answer. “From our (staff) perspective we always try to do the best we can,” she said.

Allen reported that no one is really sure how much money intended for Medicare patients is lost every year to fraud. But in 2008 alone, he learned, Medicare recovered more than $20 billion.

A Washington Post story last year — about a woman who bilked Medicare out of $105 million over four years by submitting 140,000 false claims — reported that law enforcement authorities estimate the total amount lost annually to fraud is in the $60 billion range.

In that same story, then-Attorney General Michael Mukasey was quoted as saying, “For every crooked company we bust, there is another one to replace it before the ink on the indictment is dry.”

Fraud represents a cost to all taxpayers. Directly hit, however, are Medicare patients. They pay for a lot of the fraud through higher premiums.

Congress should appropriate more money for Medicare fraud investigators. The dollars being lost through this crime are so immense that obviously the perpetrators do not fear the odds of getting caught. The odds need to start turning in favor of the taxpayers.