Medicare ‘pay and chase' issue being addressed
Medicare — and how to “save” it — has been one of the big topics for this year's presidential election.
The solutions offered have generated controversy, but there should be one thing that encourages agreement and that is the need to eliminate fraud in the program.
Government officials estimate fraud results in losses of more than $60 billion each year in the Medicare program. Often the cheating is eventually detected but by that time payments have already been sent out and it is difficult to chase down those responsible and get repayment of the money.
Often the fraud is not committed by an individual these days but by organized networks of criminals who know how to manipulate the system with bogus claims and then disappear after they get the money, perhaps to start over again. Sometimes the money even ends up out of the country.
That is why the opening of a new high-tech fraud “command center” by the government is so important.
The intention is to use computer technology to more quickly verify that claims are legitimate before payments go out. That will head off the current “pay and chase” situation.
Medicare is a vital program for the nation's seniors who otherwise could not afford expensive medical care. Both the patients and the providers are anxious to have the claims paid as quickly as possible. The desire is that the high-tech approach will allow that to continue without leaving open the door for fraud to take place.
The success of the center could also help head off complaints from lawmakers and others that the Medicare system is full of waste and that in turn could help build support for Medicare.