Medicare

Medicare is overwhelmed in its efforts to keep pace with, much less stay ahead of, those bent on cheating the system. Various factors converge to create a particularly rich environment for profiteers. These include the following: (1) weak fraud and abuse controls to detect questionable billing practices, (2) few limits on those who may bill--companies using post office box numbers have qualified to bill the program for virtually unlimited amounts--and (3) overpayment for services. This testimony describes how providers exploit the system, why they are able to do so, and what steps Medicare has taken and what remains to be done to protect the program and the taxpayers against fraudulent reimbursement schemes and abusive billing practices.