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Medicare fraud

If Washington wants to lower the costs of health care it should start cracking down on scammers bilking the system, argues former Republican House Speaker Newt Gingrich and other conservatives in a timely new book.

“Stop Paying the Crooks: Solutions to End the Fraud that Threatens Your Healthcare,” available in September when Congress will restart negotiations on health care reform, is filled with examples of waste, fraud and abuse in the health care system.

“There is hundreds of billions of dollars a year in fraud and stunningly, it is not part of the current debate that has consumed Washington,” said Jim Frogue of the Center for Health Transformation, who edited the book. Mr. Gingrich wrote the foreword and he has been promoting the book on various television and radio programs.

Mr. Frogue said that anyone interested in learning about medical fraud should look to Miami. “South Florida is ground zero for health care fraud,” he said. According to the U.S. Attorney’s Office, 245 people in the South Florida area were charged with Medicare fraud involving $793 million in fraudulent claims in 2008 alone.

Earlier this month, Miami physician Keith Russell and his assistant Jorge Luis Pacheco were each sentenced to 97 months in prison for billing Medicare more than $10 million for unnecessary HIV treatments. Another assistant, Eda Marietta Milanes, received 63 months. The three, authorities said, manipulated blood samples to make it appear their patients had HIV for the purpose of billing Medicaid for the expensive treatment. They paid their patients $200 kickbacks to keep quiet; one patient testified he used the bribe money for cocaine.

But the problem is not limited to Florida. A Medicare Fraud Strike Force, created by the Justice Department in 2007, has obtained indictments on more than 293 individuals and organizations that collectively have billed the Medicare program for more than $680 million from across the nation.

Yet, Washington politicos haven’t given much attention to rampant fraud within this government-run program.

“The people who run Medicare and Medicaid seem pathologically incapable of looking at this in a serious way,” Mr. Frogue said. “It’s sad. Almost no one else is talking about this in a serious way and we’re talking about hundreds of billions of dollars in savings that could lower costs.”

The authors in the book also highlight fraud in private insurance and propose several solutions on how to increase accountability in those programs.

Food stamp link

A new study has found a connection between obesity and women who use food stamps.

By following people who participated in the government’s Food Stamp Program over 14 years, researchers found the body mass index of females participating in the program increased faster when they used the food stamps and gained more weight as they used them over time.

Male food stamp users, on the other hand, did not gain weight like female participants did.

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