Health bureaucracies hampered by fraud
The Oklahoma attorney general's office has filed 16 counts of Medicaid fraud against the manager of an Oklahoma City optometry clinic. Robert C. Camp Jr. allegedly billed the Oklahoma Health Care Authority $359,459 for eyeglasses that were never manufactured or delivered in 2011. Even after the clinic closed, Camp reportedly billed OHCA for 57 additional pairs of glasses.
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This isn't the first such case. In 2011 Lance Faulkner, a prosthetic limb maker in Tecumseh, was indicted for illegally seeking more than $4 million from Medicare and Medicaid without proper prescriptions. In many instances, no prosthetic was delivered.
Medicare losses are estimated to total at least $60 billion annually to waste, fraud and abuse. Sadly, the government is often inept at detecting even obvious fraud. In a Wall Street Journal op-ed, former U.S. Sen. George LeMieux, R-Fla., noted that Medicare and Medicaid spent $102 million over four years to find just $20 million in overpayments.
LeMieux authored a law allowing the use of analytics technology to identify fraudulent Medicare/Medicaid payments, as is common among banks and credit card companies. But instead of using vendors with a background in predictive analytics technology, the government awarded the contract to defense and telecommunications contractors. Not surprisingly, the results have been less than stellar.