Speedy reinstatements undermine Medicare anti-fraud efforts

Oct 18 2011

An AP review shows that regulators frequently suspend Medicare providers but then quickly reinstate them -; which often leads to a missed chance to stop the flow of dollars to "bogus" companies.

The Associated Press: AP: Medicare Yanks Licenses, Gives Them Right Back
Regulators fighting an estimated $60 billion to $90 billion a year in Medicare fraud frequently suspend Medicare providers, then quickly reinstate them after appeals hearings that government employees don't even attend, according to an Associated Press review. Federal prosecutors say the speedy reinstatements -; though helpful to legitimate suppliers who get snagged on technicalities or minor violations -; amount to a missed chance to cut off the flow of taxpayer dollars to bogus companies that in many cases wind up under indictment (10/16).

In related news, the Houston Chronicle reports on a specific example of Medicare fraud.

Houston Chronicle: Doctors Who Oversee EMS Companies Sanctioned
A rocky six years dogged Houston physician Benjamin Echols even before his February indictment for fraud and accusations that he accepted kickbacks from a home health care company that earned $6.4 million in Medicare payments. Yet, a Houston Chronicle investigation found the 62-year-old gastroenterologist still keeps watch over nine private Emergency Medical Services ambulance companies that also collected Medicare money -; at least $19.4 million in the past five years. Echols is one of dozens of local doctors known as "medical directors," whose job it is to make sure that EMS companies follow proper medical standards (Langford and Wang, 10/16).