A Small Rant on Medicare waste

[Hobson]

Anybody else have this happen?

A few days ago I received 8 COVID antigen tests in the mail. I didn't order these. I apparently got on a list through the "Medicare COVID OTC Program." I previously received 8 tests from a different supplier and noticed that Medicare was billed for $240 and paid $94. In both cases the tests were expiring in less than 2 months. I can get 5 tests from Costo for $32 and they won't be expiring soon. On a nationwide scale, this seems like a giant waste of Medicare funds. I have plenty of tests on hand and I didn't ask for more. A note inside the package says that I can opt out by scanning the bar code. A note on the outside of the package says that I can opt out by calling or texting. I texted. We'll see what happens. I did once order some (I think 4) free tests through USPS. Maybe that's how this started, but I don't see how these companies got my Medicare ID.

[Hobson]

Kinda looks like it won't matter once the COVID emergency declaration ends on May 11. www.webmd.com/covid/news/20230201/covid-emergency-orders-ending-whats-next

[Cornflake]

I do have a different view. We have used every test kit mailed to us except for a few we shared with others. Without those kits, my family and many others would have been slower to get tests when we needed them. The effects of unvaccinated people spreading the disease would have been much more expensive in money and lives. But I don't think less of you because we disagree on this.

[TKennedy]

There is some waste but if we could eliminate Medicare and other government entitlement fraud we could probably easily finance national health care. But then again that would just be a hotbed for even more sophisticated fraud.

[Hobson]

Flake, I do see your point. And in the big picture, distributing free tests to everyone is probably the best approach. We are lucky. Mr. H and I have not had COVID, as far as we know. We only tested once and that wasn't because we were exposed. We had tests that were expired and used them to see how they worked. Better to have some that we don't need than to have to try to get them when needed.

[Cornflake]

Hobson, I get it. And all any of us can do is explain how things look from our point of view, as you've done.

Here's how things look to me at the moment: My son and I had never had Covid until recently. Now we both have it. It's common up here, though invisible to most people. We're both having relatively mild cases for various reasons. One is that we are fully vaccinated and boosted. Another is that Covid is a different bug than it once was. Still another is that what we know about Covid has grown from nothing to a heck of a lot since it first appeared. I don't think we should fault ourselves for not having known what we couldn't know until we learned it. That's true of individuals and the government.

And I may be wrong. Don

[Hobson]

I ended up receiving a total of 4 sets of tests. But there were 6 claims to Medicare from 5 different companies. One of the claims was denied.

Then, the $hit hit the fan. There was a claim for over $2,000 for medical equipment that I never ordered, never got, and don't use. Today I called Medicare and talked to the fraud department. Since I was calling anyway, I also mentioned the COVID tests that I never ordered. It took over an hour because the poor woman had to separately pull up each claim, fill out a report, and then read me a statement about fraud. I get it. I'm a retired auditor and worked for 2 different departments in the federal government.

What I suspect is that somebody at the surgery center where I had my cataract surgeries is or was providing patients' billing information to a gang of companies that specialize in ripping off Medicare. I know for a fact that the surgery center was using a contractor for their billing and no longer are. This all started within a few days of my first cataract surgery. But nobody wanted to hear my theory and it is just a theory. I normally only log on to Medicare when I know I have a claim. Guess I'll have to start checking periodically even if I'm not expecting any claims.

[TKennedy]

COVID fraud has been estimated at 76 billion dollars I read somewhere. I would guess if the student loan reimbursement had gone through it would have been another hotbed of fraud. Medicare certainly has been for a long time. Someone said around 80 billion a year.

It’s a jungle out there, Marty’s wife knows all about that.

[epaul]

If somehow all fraud and waste in government programs were eliminated, our economy would probably collapse. You don't just pull 6.5 trillion dollars out of circulation without leaving a pretty big hole.

[t-bob]

I has new self tests - two weeks - not Covid19/ variant

[jdd2]

Jul 5, 2023 14:21:15 GMT -5 epaul said:

If somehow all fraud and waste in government programs were eliminated, our economy would probably collapse. You don't just pull 6.5 trillion dollars out of circulation without leaving a pretty big hole.

Florida is doing its part with property insurance fraud, lawsuits, and so on. Not sure about dollar value, but it's certainly systemic abuse.

wapo.st/3CYLxxc

[Hobson]

I received another Medicare Summary Notice today and now have a new suspect. There were 2 claims for COVID tests that I never ordered or received. Both recently submitted, but one was for November 2022 and the other for July 2022. The service date for July was the same date that I first saw a specialist. Coincidence? Don't know, but I'm calling Medicare again tomorrow to add these 2 claims to the list to look into.

To be clear, the fraud so far is against Medicare, not me. So it's up to them to decide what to do.