Although legitimate institutions worry about Medicare billing accuracy every day, there are other providers who work to milk the payment system.

These providers or services often have been small enough to fly under Medicare’s radar.

That just changed. It is safe to expect this to be the beginning of more busts.

AP

…”Authorities said busts carried out this week in Miami, New York City, Detroit, Houston and Baton Rouge, La., were the largest Medicare fraud takedown in history — part of a massive overhaul in the way federal officials are preventing and prosecuting the crimes.

“In all, 94 people — including several doctors and nurses — were charged Friday in scams totaling $251 million. Federal authorities, while touting the operation, cautioned the cases represent only a fraction of the estimated $60 billion to $90 billion in Medicare fraud absorbed by taxpayers each year.

“For the first time federal officials have the power to overhaul the system under Obama’s Affordable Care Act, which gives them authority to stop paying a provider they suspect is fraudulent. Critics have complained the current process did nothing more than rubber-stamp payments to fraudulent providers.” (Emphasis added)

Source: AP,  July 17, 2010