Fraud Continues to Plague Medicaid System
July 11, 2012 By John R. Vermillion & Associates, LLC
Medicaid, the joint state and federal health insurance program designed to provide health care to the poor, needy, disabled, and elderly, loses billions of dollars in losses every year. Soon, that number may soon increase when the Affordable Care Act expands Medicaid coverage to millions more Americans. Of the $400 billion spent on Medicaid last year, it’s estimated that about 8% of it was lost to fraud and abuse.
Healthcare providers who file fraudulent claims cost the federal government alone $22 billion per year. States also incur a significant loss because of such fraudulent claims.
Medicaid currently covers about 60 million people, though that number is expected to expand greatly under the terms of the healthcare expansion law. Unless the Supreme Court overturns the Medicaid provisions of the law, all states will have to adopt expanded Medicaid guidelines by 2014.
Many states are still dealing with the financial impact of the recession and are having difficulty paying for Medicaid programs. Medicaid already makes up the single largest budget item on most, if not all, state budgets. Many states have proposed drastic cutbacks in Medicaid programs to help deal with the budget crisis, but all face increased Medicaid payments with the 2014 deadline.
Though Medicaid fraud currently accounts for billions of dollars every year, the amount lost to fraudulent claims has been decreasing. The 8% lost to fraud and abuse in 2011 is down from 11% in 2008. However, because each state has its own Medicaid system, it’s difficult for states to find a uniform system that all can apply to help prevent fraud and abuse.
ABOUT THE AUTHOR: John Vermillion
Experienced estate planning attorneys Dallas TX of the John R. Vermillion & Associates, LLC offers estate planning and business planning resources to residents of Dallas TX.
Copyright John R. Vermillion & Associates, LLC
More information about John R. Vermillion & Associates, LLC
Disclaimer: While every effort has been made to ensure the accuracy of this publication, it is not intended to provide legal advice as individual situations will differ and should be discussed with an expert and/or lawyer. For specific technical or legal advice on the information provided and related topics, please contact the author.
Medicaid currently covers about 60 million people, though that number is expected to expand greatly under the terms of the healthcare expansion law. Unless the Supreme Court overturns the Medicaid provisions of the law, all states will have to adopt expanded Medicaid guidelines by 2014.
Many states are still dealing with the financial impact of the recession and are having difficulty paying for Medicaid programs. Medicaid already makes up the single largest budget item on most, if not all, state budgets. Many states have proposed drastic cutbacks in Medicaid programs to help deal with the budget crisis, but all face increased Medicaid payments with the 2014 deadline.
Though Medicaid fraud currently accounts for billions of dollars every year, the amount lost to fraudulent claims has been decreasing. The 8% lost to fraud and abuse in 2011 is down from 11% in 2008. However, because each state has its own Medicaid system, it’s difficult for states to find a uniform system that all can apply to help prevent fraud and abuse.
ABOUT THE AUTHOR: John Vermillion
Experienced estate planning attorneys Dallas TX of the John R. Vermillion & Associates, LLC offers estate planning and business planning resources to residents of Dallas TX.
Copyright John R. Vermillion & Associates, LLC
More information about John R. Vermillion & Associates, LLC
View all articles published by John R. Vermillion & Associates, LLC
Disclaimer: While every effort has been made to ensure the accuracy of this publication, it is not intended to provide legal advice as individual situations will differ and should be discussed with an expert and/or lawyer. For specific technical or legal advice on the information provided and related topics, please contact the author.
