Medicare Fraud: Walkers For Paraplegics

You just have to shake your head in wonder.  What next?

The Assoicated Press revealed Monday that Republicans on the Senate Homeland Security investigations subcommittee  found billions of taxpayer dollars wasted  in Medicare payouts for fraudulent claims since 2001 . 

Amidst the fraud uncovered in the subcommittee’s report, AP wrote, was “more than $1 billion in questionable Medicare claims for medical supplies that showed little relation to a patient’s condition…”   Some examples of these fraudulent Medicare billings listed in the Senate report are so glaring that it is nearly impossible to imagine how they were not detected when the government originally received the invoices :

• Blood glucose tests for typhoid and bubonic plague.
• Blood glucose strips for sexual impotence.
• Blood glucose strips for airway obstruction.
• Special diabetic shoes for leg amputees.
• Wheelchairs for deformed noses.
• Wheelchair accessories for sprained wrists.
• Walkers for paraplegics.

In addition, the AP states, Senate investigators, after reviewing millions of Medicare claims that were paid by the government,  found incorrect or blank diagnostic codes, or in some cases, codes consisting of “smiley faces” and other unrelated symbols. 

Great fodder for those who question the government’s ability to manage massive federal and state programs, but the politics of this stunning report are not the concern here at PRAXIS.  We simply wonder why so many Americans find it possible to lie, cheat, and defraud their own government, their fellow citizens, heck – themselves – out of billions of taxpayer dollars? 

PRAXIS Executive Vice President, Dr. CJ Walker said, “Frankly, this report is not surprising.  Our research found earlier studies estimating combined  Social Security and Medicare waste/fraud ranging from $80 billion to $120 billion annually. ”

How can this happen?  If the current sociological take on human nature that sees people as essentially good, honest, and apt to be behind closed doors who they are in public is accurate, then this fraud is perpetrated by a tiny minority of health care providers who happen to have developed a deficient world view when it comes to personal ethics.  But is this truly the case?  Or does the Senate report cast additional light on a growing societal epidemic infection the intergrity of more and more Americans – utilitarianism - ”what is moral is what benefits me?”

The Senate report hints that hundreds, if not thousands of different providers submitted fraudulent billings to the government.  While we do not yet know the overall percentage of the total number of persons submitting invoices that these frauds comprise, we do know that even a dozen are too many. 

Pessimists would dismiss the numbers as understandable given that “no one can be trusted when it comes to money.”  Pragmatists might suggest that tighter controls would restrain the impulse to cheat, and lack of stringent oversight is really to blame. 

While there is some merit in both arguments, PRAXIS believes that a culture that lifts up honesty, integrity, and putting others first in visible and progressive ways, in all areas of life, can not only inform potential Medicare cheats, but transform them into people who strive to be honorable in all they do.  The Senate report is quite illuminating, helpful, and  suggestive along those lines.

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