Sunday, February 10, 2008

Does healthcare fraud tie into organized crime, illegal immigration and .... corporations?

Read a pretty interesting article about how identity theft is being used (more and more frequently) to commit healthcare fraud. The article also alleges that organized crime is exploiting this activity to their financial advantage.

Since organized criminals normally are hard to get a "quote" from, we'll have to speculate about how much they are involved in this phenomenon.

The article written by Jim McKay appeared in govtech.com and quoted a section chief (Sharon Ormsby) from the FBI:

At least 3 percent of U.S. health-care costs (about $60 billion) can be attributed to fraud, according to the National Health Care Anti-Fraud Association. Of that, 1 percent is attributed to medical ID theft - an ominous figure when the numbers are triangulated, according to Sharon Ormsby, section chief for the financial crimes section of the FBI.

"If you figure by 2012, national health-care expenditure costs for the country will be approximately $3 trillion, you look at the fact that the National Health Care Anti-Fraud Association conservatively estimates health-care fraud to be 3 percent to 5 percent of that expenditure amount," she said. "That's a significant amount of fraud, so we do have a strong interest in it."

Another interesting article related to the subject of healthcare fraud showed up in the news in the past few days, also. CBS News did a story about a "whistleblower," who turned in his superiors -- in this instance a hospital -- for fraudulently billing government healthcare programs.

Unlike the govtech.com article -- which only suggests a dollar loss -- the CBS piece estimates the cost of healthcare fraud at about $11 billion a year.

Sharyl Attkisson, a CBS correspondent covered this story and it points to more commentary about government waste in general on the Couric (Katie) and Co. blog.

Please note the whistleblower in this instance received $3 million for turning in his employer.

With the baby boom generation headed for retirement and reports of hospitals going under because they provide free healthcare for illegal immigrants, there is a lot of camouflage for healthcare fraud to hide in.

The fact that a hospital was in on the fraud shouldn't surprise a lot of people, either. If you are following the 2008 election, the subject of legitimate companies gouging the healthcare system for profit isn't a new topic.

There is little doubt that the subject of healthcare costs is a hot topic and will continue to be for a long time to come.

Govtech.com article, here.

Here is a story, I did in May that covers the ties between healthcare fraud, organized crime and illegal immigration:

Medicare Fraud arrests might expose ties to medical identity theft and organized crime

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