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Fraud is a small part of health reform
The costs of an overhaul to health care
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Bill Radke: Today the Senate Judiciary Committee shines a light on the issue of heath-care fraud. Fraud is one of the biggest money-wasters in our medical system. But it's been a relatively small part of the debate, as Marketplace's Joel Rose tells us.
Joel Rose: Health-care fraud accounts for as much as $175 billion a year, according to a study released this week by Thomson Reuters. That's a lot of potential savings -- if you can find the fraud.
Louis Saccoccio at the National Health Care Anti-Fraud Association says that's not always easy to do.
Louis Saccoccio: You have about 4 billion claims being filed every year. Plus you have the entire range of health-care problems: all the diseases, all the injuries, etc. So it becomes a very, very enormous and complex system to really go in and detect the fraud that's there.
Saccoccio says the Justice Department has made some progress lately by focusing on cities with high rates of medical fraud, including Miami and Los Angeles.
The health-care overhaul bills in Congress would give law enforcement some new funds to analyze and fight the problem. But those bills would also expand access to health insurance and care. And Saccoccio points out that would mean more fraud, not less.
I'm Joel Rose for Marketplace.
Oops! Joel, I just sent an email about the OIG's role in health care fraud. I need more coffee. The actual figure for OIG receivables resulting from its investigations of fraud, waste and abuse in the healthcare system is nearly $4.4 billion.
Good morning, Joel. I'm with the HHS Office of Inspector General (202-619-1028) and we heard your brief story on today's hearings about fraud. Please consider us a resource. As you may know, OIG investigators play a key role in ferreting out fraud, waste and abuse in the healthcare system. For the 6 months ending in March, OIG reported expected recoveries of nearly $280 billion. A major investigation resulted in Pfizer paying $2.3 billion to settle charges it promoted drugs for off-label purposes. It would be great if you could include information in your stories about the important role OIG plays. Feel free to give me a call for additional information or to arrange an interview.
