Within Medicare, improper payments last year exceeded the estimated annual earnings of roughly 214,000 primary care doctors — the figure amounting to almost $57 billion. No one truly knows how much is lost in total to Medicare fraud, of which certain improper payments make up a part. However much it is, it is much more than it ought to be. Earlier in September, the Centers for Medicare & Medicaid Services announced that it identified 11 durable medical equipment, prosthetics, orthotics, and supplies companies, which sought to break into the lucrative, uncapped trillion-dollar Medicare vault by billing for equipment for the deceased or beneficiaries who never requested or received it. Over the past two years, these suspected fraudsters attempted to siphon off as much as $3.4 billion.
The structure of the federal administrative apparatus fosters mismanagement and conditions ripe for criminal activity, costing taxpayers a quarter to half a trillion dollars in fraud annually. Even so, there are bad approaches and better ones. The CMS is transitioning from the former to the latter, demonstrating that federal agencies can improve welfare program integrity when they prioritize doing so.
