« Medicare Fraud: A $60 Billion Crime (CBS 60 Minutes, October 25) »
- Video: CBS 60 Minutes, Broadcast October 25, 2009
- "Tony" claims he stole more than $20-million dollars from the Medicare system before he was arrested (1:24).
See also:
Look Who's Really Writing The Healthcare Bill -- Big Pharma & The Insurance Lobby
- Medicare and Medicaid fraudsters are beating U.S. taxpayers out of an estimated $90 billion a year using a billing scam that is surprisingly easy to execute (14:04).
*************
From 60 Minutes
Of all the problems facing the United States right now, none are more important than health care.
President Obama says rising costs are driving huge federal budget deficits that imperil our future, and that there is enough waste and fraud in the system to pay for health care reform if it was eliminated.
At the center of both issues is Medicare, the government insurance program that provides health care to 46 million elderly and disabled Americans. But it also provides a rich and steady income stream for criminals who are constantly finding new ways to steal a sizable chunk of the half trillion dollars that are paid out each year in Medicare benefits.
In fact, Medicare fraud - estimated now to total about $60 billion a year - has become one of, if not the most profitable, crimes in America.
This story may raise your blood pressure, along with some troubling questions about our government's ability to manage a medical bureaucracy.
If you want to find Medicare fraud, the first place you should look is South Florida, where 60 Minutes and correspondent Steve Kroft were told it has pushed aside cocaine as the major criminal enterprise.
It's a quiet crime - there are no sirens or gunfire. The only victims are the American taxpayers, and they don't even know they are being ripped off.
FBI Special Agent Brian Waterman, who 60 Minutes rode with for several days, told us the only visible evidence of the crimes are the thousands of tiny clinics and pharmacies that dot the low-rent strip malls.
You don't even know they're there because there's never anyone inside. No doctors, no nurses and no patients.
"This office number should be manned and answered 24 hours a day," Waterman explained, standing outside one of those small, unstaffed businesses.
The tiny medical supply company billed Medicare almost $2 million in July and a half million dollars while 60 Minutes was there in August, but we never found anybody inside, and our phone calls were never returned.
Sometimes, they don't even have offices: we went looking for a pharmacy at 7511 NW. 73rd Street that billed Medicare $300,000 in charges. It turned out to be in the middle of a public warehouse storage area.
"They've already told us that there's no offices here," Waterman told Kroft. "There are no businesses here. In fact they are not even allowed to have a business here."
Waterman is the senior agent in the Miami office in charge of Medicare fraud. And Kirk Ogrosky, a top Justice Department prosecutor, oversees half a dozen Medicare fraud strike forces that have been set up across the country.
The office Kroft visited operates out of a warehouse at a secret location in South Florida and includes investigators from the FBI, Health and Human Services, and the IRS.
"There's a healthcare fraud industry where people do nothing but recruit patients, get patient lists, find doctors, look on the Internet, find different scams. There are entire groups and entire organizations of people that are dedicated to nothing but committing fraud, finding a better way to steal from Medicare," Waterman explained.
"Is the Medicare fraud business bigger than the drug business in Miami now?" Kroft asked.
"I think it's way bigger," Ogrosky said.
Asked what changed, Ogrosky told Kroft, "The criminals changed."
"Sophistication," Waterman added.
"They've figured out that rather than stealing $100,000 or $200,000, they can steal $100 million. We have seen cases in the last six, eight months that involve a couple of guys that if they weren't stealing from Medicare might be stealing your car," Ogrosky explained.
"You know, we were the king of the drugs in the '80s. We're king of healthcare fraud in the '90s and the 2000's," Waterman added, speaking about South Florida.
Read the complete transcript HERE
************************
Post Video To Your Facebook Profile
Please Help by emailing our stories to a few friends. No less than your children's future is at stake. Oh and the fate of the greatest Democracy in the history of the world also hangs in the balance as we teeter toward bankruptcy. But honestly, don't worry about it. Go about your day. And don't forget to DVR American Idol. You really don't want to miss that.
From tonight's 60 Minutes broadcast. Runs 14 minutes. You won't be happy when you see this. Highly recommended.
Sunday, October 25, 2009 at 10:17PM
View Printer Friendly Version
Email Article to Friend
Reader Comments (16)
Why doesn't he prove how much money he can save us by going after that fraud before adding more opportunities for fraud.
What do you think Obama is really after?
I don't know if it was deliberate, but this captures the bailout zeitgeist perfectly.
Here is a solution. Volunteers. If people in every city would participate we could significantly reduce Medicare fraud.
This would involve volunteers looking in the phone book to see who is selling medical equipment in their area and visiting the street address of those companies. If upon visiting these medical equipment companies there things appeared suspicious ( no customers, no medical equipment, no personnel present, or no actual store ) they could report this to a Federal Medicare central clearing house which would investigate further.
I am sure there would be plenty of folks interested in participating and helping their country and their pocket books simultaneously. Here is a way to put Obama's focus on patriotism and national service to work and to save all of us significant tax dollars.
I tried to state it several different ways...but it's impossible....you're gonna hate it paired with how important it is to see...bailout zeitgeist it is...well put...
The law defends the plunderer.
bailout zeitgeist is good, Steve, you might like the original one.
* Democracy is an illusion that insults our intelligency, in a monetary system there is no such thing called democracy, and has never existed.
* Political parties only respond to the interest of the corporate institutions that finance and point who is going to lead the government for the next period.
* It's time now to transcend this failure and overcome any mental barrier towards other form of organization.
War is just a racket. There are only two things we should fight for. One is the defense of our homes and the other is the Bill of Rights. War for any other reason is simply a racket.
It may seem odd for me, a military man to adopt such a comparison. Truthfulness compels me to. I spent thirty-three years and four months in active military service as a member of this country's most agile military force, the Marine Corps. I served in all commissioned ranks from Second Lieutenant to Major-General. And during that period, I spent most of my time being a high class muscle-man for Big Business, for Wall Street and for the Bankers.
I suspected I was just part of a racket at the time. Now I am sure of it. Like all the members of the military profession, I never had a thought of my own until I left the service. My mental faculties remained in suspended animation while I obeyed the orders of higher-ups. This is typical with everyone in the military service.
I helped make Mexico safe for American oil interests in 1914. I helped make Haiti and Cuba a decent place for the National City Bank boys. I helped in the raping of half a dozen Central American republics for the benefits of Wall Street. I helped purify Nicaragua for the international banking house of Brown Brothers in 1909-1912. I brought light to the Dominican Republic for American sugar interests in 1916. In China I helped to see to it that Standard Oil went its way unmolested.
During those years, I had, as the boys in the back room would say, a swell racket. Looking back on it, I feel that I could have given Al Capone a few hints. The best he could do was to operate his racket in three districts. I operated on three continents.
Major General Smedley Butler, two time medal of honor recipient.
Their plans to bring down the world’s economic and financial structure is well underway. The problem is that the public has begun to discover what they are up too via talk radio, the Internet and publications such as the International Forecaster. That has caused the elitists to accelerate their plans and that has opened the window of opportunity for us.
This is why now it is the appropriate time to pass HR1207 and SB604, bills to audit and investigate the Federal Reserve. Once the public discovers what these elitists have been doing to the American people for almost a century, they will disband the Fed and turn its job of monetary policy back to the Treasury where it was placed by our Constitution. This way we will have control and transparency. The next step will be to close the revolving door between Wall Street and Washington.
So the government first steals my money (taxes are theft), then incompetently redistributes it to the sick and old through medicare such that 60 Billion a year or more is stolen and your solution is to have me (the one who's money was originally stolen) spend my time policing the streets to find the theft.
Um and maybe it's just me, but I think a better solution would be to STOP THE ORIGINAL THEFT OF MY MONEY!!!!!!!
Fraud could be much higher than $60-90 Billion.
c.200B Medicare
700B TARP
787B Keynesian "stimulus"
c.200B Iraq War
------------
1,887B Waste, fraud and abuse
No matter how you slice that turkey, that's a whole lot of waste, fraud and abuse. I'm with 6-year old Cody on this one.
You mean this cody of course
http://dailybail.com/home/the-next-generation-speaks-its-not-my-debt-video-collage.html
A 1% bounty on fraud prevention. Set up a hotline to the FBI/Medicare Fraud Prevention. Allow people that receive a "Explanation of Benefits" statement with fraud to report it. Also amend the law to allow for a "disputed or pending fraud inquiry" so that a proper inquiry can be processed prior to the $money$ disappearing.
This gives medicare recipients / bounty hunters the incentive to help police the transactions and instantly turns the medicare fraud targets (recipients) into investigative bird dogs. Rewards them with a fraction of the savings (helps some of the unemployed, seniors) and helps Law Enforcement by putting them onto a HOT trail.
Good idea...might be tough to implement given their size...remember they have no IT whatsoever... they need an IT overhaul as do many agencies...
The Washington Post
May 27, 2002
By Bill Brubaker
Anthony Welters grew up in a one-room tenement in Harlem, sleeping behind a curtain with his three brothers, he says. Today, he lives in a five-bedroom, seven-bathroom house on five acres in McLean. He has a 75-acre farm in the Blue Ridge Mountains. For a change of pace, there is a 5,000-square-foot house in Aspen, Colo., recently assessed at $3 million. Welters, 47, made his fortune in health insurance, serving a specialized market. The market is the poor. Federal and state audits concluded in the early and mid-1990s that ineffective oversight by Pennsylvania officials had enabled Welters and his partners to make too much money from their taxpayer-supported business. The audits said the Welters group had paid itself millions of dollars in management fees -- paid to other companies they controlled -- and millions more in bonuses.
Welters's health-insurance business expanded to New York in 1994 and New Jersey in 1996. In both states, the HMO was known as Managed Healthcare Systems (MHS). In New York, state investigators discovered something was not right about two clinics that MHS retained to serve patients in the borough of Brooklyn.
They determined that from 1995 to 1997 the clinics were being staffed largely by "unsupervised physician assistants or nurse practitioners," New York state Attorney General Eliot Spitzer announced in May 2000. The investigation also found that patients were "consistently complaining that they were having difficulty getting services or being seen by a doctor." MHS "failed to take any corrective action or properly oversee" the clinics. Spitzer announced a settlement in which MHS repaid more than $2 million to the Medicaid program for services the clinics never provided. In October 2000 MHS changed its name to AmeriChoice of New York. Anthony Welters, Chairman of AmeriChoice Corp.: "What [should] a person who takes a $200,000 investment and turns it into a billion-dollar company . . . receive? I don't know. But I know this: I'm not going to apologize for it."
<http://www.washingtonpost.com/wp-dyn/articles/A14254-2002May26.html>http://www.washingtonpost.com/wp-dyn/articles/A14254-2002May26.html
Comment: Medicaid's chronic under-funding threatens access to care for the low-income individuals covered by this program primarily because many providers will not participate at rates that frequently do not even pay overhead expenses. Several state governments have turned over their Medicaid funds to private corporations to administer these programs. Mr. Welters exemplifies how well these plans fulfill their corporate responsibility to their shareholders and executives.
Beatrice Wilkinson Welters is President Obama's nominee for ambassador to Trinidad and Tobago. No surprise, her husband Anthony Welters, is an executive with UnitedHealthGroup which brought in $200,000-$500,000 in campaign donation for the election and another $100,000 for the Obama crowning inaugural. Beatrice Welters donated $4,600 to the Obama campaign in each of the years 2007 and 2008. Her husband, Anthony donated $4,600 in 2008. The Welters' two sons were also $4,600-donors: Bryant, reportedly 19 years old today, donated $4,600 in the second quarter of each of the years 2007 and 2008, when he was an unemployed student, and Andrew, reportedly 17 years old today, an unemployed student, donated $4,600 in the second quarter of 2008.
http://maggiesnotebook.blogspot.com/2009/11/beatrice-wilkinson-welters-ambassador.html
BACKGROUND*
Anthony Welters has been President of Public and Senior Markets Group at UnitedHealth Group Inc. since September 2007. Mr. Welters has been Executive Vice President of UnitedHealth Group Inc., since December, 2006. He serves as Chief Executive Officer of AmeriChoice Health Services, Inc. He served as Head of Public & Social Markets Group of UnitedHealth Group since August 2007. Mr. Welters co-founded AmeriChoice Corporation (AmeriChoice) in 1989 and served as its Chief