Senate Finance Committee Combats Medicare and Medicaid Waste and Fraud

Written by: Scott Sery

It is no secret that many government run programs are often teeming with fraud and waste.  When these programs get as big as they do, they require a lot of bureaucracy in order to run.  Every added step is an opportunity for a fraudster to scam the system; an act that ultimately costs the taxpayer.  The senate finance committee put together a bi-partisan team, headed by Senator Max Baucus (D- Montana) and Senator Orin Hatch (R- Utah) to solicit advice from the field on how to more efficiently and effectively run the Medicare and Medicaid programs.  The result was over 2,000 pages of advice from 164 healthcare experts on how to make the system better.

Not surprisingly more fraud and more waste means less care for those who really need it.  After all, a dollar spent on waste is a dollar that could have gone to providing much needed supplies and treatment.  More fraud and waste means that fewer people will put their trust in the system.  It also means that more government oversight is required, which leads to higher administration costs.  By reducing both fraud and waste in the Medicare and Medicaid systems, the committee is hoping to make the programs more effective and also more popular in the eyes of the citizens.

As an administrator it is hard to determine exactly where the flaws in the system are.  So instead of arbitrarily offering solutions, the help of those who deal with it on a regular basis was sought.  Many common sense suggestions were brought forth, and the following are just some of the new methods to keep things moving efficiently.

  • Increase federal funds for anti-fraud programs.  Hopefully spending more money here will reduce the amount lost due to fraud.
  • Decrease redundancy in the program.  The doctors should not have to worry about submitting the same form to multiple different agencies and personnel.
  • Change the payment policies to prevent overpayment and fraud.  This seems pretty simple.  The doctor sees a patient, bills Medicare or Medicaid, and receives payment for services provided.
  • Require the Centers for Medicare and Medicaid Services (CMS) to use existing statutory authorities.  There are systems and agencies set up and in place.  There is no need to create new ones, when there are effective authorities already in operation.
  • Create an advisory panel to provide clinical input as a component of contractor oversight.  Rather than have these suggestions be a one-time deal, keep a panel going so the process can constantly be improved.

Now what does all this mean to the citizens of the United States?  Really, most people will not see much of a direct effect.  Beneficiaries of the programs shouldn’t notice a difference.  The only thing that will be different is that as a taxpayer, you will know that your money is being spent wisely, and the long-term outlook is that the programs will remain financially solvent.

Any time the government will take steps to being more efficient is a good thing.  However, more oversight and protection also means more spending.  Not necessarily wasteful spending, but none-the-less more output of resources.  Ideally this output will cost less than the waste and fraud are currently costing.  Keeping an eye on the Medicare and Medicaid programs we will see if over the next few years they become better oiled machines.


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Senate Finance Committee Combats Medicare and...

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