U.S. officials hunt Medicare fraud

November 7, 2006

U.S. federal investigators are hunting incidents of Medicare fraud, using sophisticated computer technology to determine unusual patterns.

In one case, investigators found a patient who had reportedly undergone a diagnostic rectal-probe procedure 118 times in a year at 21 medical facilities.

As one official told USA Today: "It's unlikely that could have occurred. This person would not have been able to sit on a plane."

The use of computer programs to find suspicious patterns is designed to help discover insurance fraud before payment.

Medicare investigators said they have also discovered cases in which improperly obtained Medicare patient identification numbers were used to bill for examinations that were likely never performed. Such discoveries have resulted in 83 diagnostic centers losing their Medicare billing privileges this year, with $163 million in payments denied.

Fraud is estimated to account for as much as 10 percent of the nation's $2 trillion healthcare spending bill.

Copyright 2006 by United Press International

Explore further: ACS and Surgical Infection Society announce guidelines for prevention, treatment of SSIs

Related Stories

Recommended for you

Study shows blood products unaffected by drone trips

December 7, 2016

In what is believed to be the first proof-of-concept study of its kind, Johns Hopkins researchers have determined that large bags of blood products, such as those transfused into patients every day, can maintain temperature ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.