Medicare apparently has over $92 million in fraudulent bills since 2000. The billing was done under the name of doctors who had been dead for as long as five years according to reports of investigators. The Centers for Medicare and Medicaid Services (CMS) was advised of the problem approximately six years ago. It looks like the problem has not been corrected. In the past eight years, CMS has apparently paid somewhere in the neighborhood of half a million of these claims.
The Medicare Fraud Strike Force came into existence in 2007 with the purpose of solving this problem. It was estimated that this fraudulent billing costs taxpayers tens of billions of dollars every year. I believe this issue of fraudulent billing makes it much more difficult to obtain reduction from CMS for those injured in personal injury accidents. Medical bills related to injuries sustained in a car accident paid by Medicare must be reimbursed by the accident victim if they receive a settlement or a jury award in their personal injury case. This lien or right to subrogation or reimbursement must be repaid. It is primary. Medicare has the right to file a lawsuit to collect the money if it is not repaid.
This fraudulent billing appears to be wide spread. I suspect that it will become more difficult than it already is to obtain reductions in these lien amounts. If you have any questions, please contact us at (502) 584-9511.