Medicare Fraud

Government urges elderly to be Medicare fraud detectives

By ANNE GEARAN, Associated Press Writer

WASHINGTON (AP) - Older Americans should learn to spot overcharges and other fraud on their Medicare statements, then report problems to the government, Attorney General Janet Reno and other officials said Wednesday.

"Medicare beneficiaries are the first line of defense" against billing fraud, Reno said.

Patients know the dates and times they see their doctors and what the doctors did, Reno said. Charges for anything else should trigger the suspicion that fraud might be involved, she said.

Administrators and enforcement officials at a news conference tried to draw more attention to anti-fraud efforts, pointing out a government hotline and new public service advertisements that depict Medicare fraud as a dripping faucet.

"We're actually asking you to be the eyes and ears of the Medicare system," Health and Human Services Secretary Donna Shalala said. "If you're suspicious, call." Shalala said the patient's doctor or the HHS fraud watchdog line at 1-800-HHS-TIPS should be called.

Close scrutiny of Medicare bills are likely to turn up more examples of billing mistakes than of actual fraud, officials said. Reno and Shalala both characterized most doctors and hospitals as honest and suggested many billing problems can be corrected with a simple call to the doctor's office.

Still, the anti-fraud campaign represents an insulting wedge between doctors and patients, said American Medical Association President Dr. Nancy Dickey.

"The government's tactics are lamentable," Dickey said in a statement. "It is counterproductive to demonize the entire medical community with the broad brush of fraud, waste and abuse."

Medicare lost about $12 billion - 7 cents of every dollar spent – to fraud, waste and mistakes in 1998, government auditors said this month.

The loss is about half what it was two years ago, due in part to stepped-up enforcement, Shalala said.

Meanwhile, a survey released in conjunction with the anti-fraud effort indicated Americans believe fraud runs rampant in the health-care system and that little is done to curb it.

Almost 90 percent of those surveyed believe health-care fraud is increasing or holding steady, and close to eight in 10 said they are unaware of efforts to reduce the problem, the survey released by AARP suggested.

About 80 percent of those surveyed thought health-care fraud is either extremely widespread or somewhat widespread.

The December 1998 telephone survey of 2,000 adults by ICR/International Communications Research of Media, Pa., has a margin of error of 2 percentage points.

The American Association of Retired Persons, the largest organization of older Americans, will pay to train a volunteer corps of Medicare detectives. Those tutors will then teach larger groups of elderly people how to read their bills.