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Dummy Firms Squeeze Millions From Medicare

Fraud-fighters finding it hard to stay ahead of shell companies

By Rob Quinn,  Newser Staff

Posted Dec 22, 2011 4:42 AM CST

(Newser) – Fraudsters using complicated networks of ghost companies are sucking hundreds of millions of dollars out of Medicare every year and it's a bit like taking candy from a baby, a Reuters investigation finds. The probe—which officials say will likely lead to a criminal investigation of the firms involved—found that the "companies" of many Medicare providers are registered to nonexistent addresses, or the addresses of abandoned buildings. The thieves use stolen doctor and patient data to bill Medicare for as much money as possible in a short time.

Last year, one gang alone used phantom firms to bilk Medicare of $163 million. Incorporation laws vary from state to state, and often make it easy to set up fake companies, say investigators, who compare stopping the constant stream of scams to playing "whack-a-mole." Part of the problem, investigators say, is that Medicare lacks the resources to review the addresses and backgrounds of providers, leading to a system in which Medicare pays first and asks questions later. But Medicare may soon be able to get ahead of the scams: Health care reform includes $350 million over a decade for anti-fraud measures, and new screening procedures will be introduced next month.

Less than 5% of Medicare payments are subject to audits, making it easy for fraudsters to steal millions from the program.
Less than 5% of Medicare payments are subject to audits, making it easy for fraudsters to steal millions from the program.   (Shutterstock)
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Every time Medicare gets close, every time Medicare clamps off one path, it never occurs to them to stop stealing. They just evolve the scheme and steal some more. - Ryan Stumphauzer, former assistant US attorney in Miami

These companies are nameless, faceless entities collecting billions in secret. - Patrick Burns, director of communications for Taxpayers Against Fraud

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COMMENTS
Showing 3 of 13 comments
Alwaysmilin
Dec 25, 2011 8:24 PM CST
@Toeser; or they could run for governor of Florida. Chances are they'll win. Rick Scott did.
jamiealex1569
Dec 24, 2011 3:34 PM CST
See! With what these greedy ass computer hackers are milking out of the medicare system every year, that amount would cover probably at least 100,000 hard working AMERICANS who have paid into the system to be able to recieve medicare when they are hurt, or old enuf to file for it!!! The government needs to crack down on all this bullshit, and stop cutting the funds to the TAX PAYING AMERICAN CITIZENS!!!!! Any person that is behind any of these schemes should have EVERY ASSET they have down to their clothes auctioned off to put the money they stole back into the system! And that includes any government official who chooses to barrow money out of the Medicare pot!!!! This money is meant for THE HARD WORKING AMERICAN TAX PAYING CITIZENS who have worked and paid in all their lives so that they can retire, It's not meant for government officials to use it for foreign aid or anything that the government feels fit to use it for!!! It's not THEIR MONEY to make decisions with!! It's OUR MONEY THE TAX PAYING AMERICAN CITIZENS MONEY!! Were the ones that paid in and we're the ones that should be paid back!!!!!!!
fractal
Dec 22, 2011 4:17 PM CST
One reason this charade is still going on, is the silly urban myth of the deadbeat urban welfare "heifer".  Righty will buy into any crazy notion the rich spoon feed them, if it backs up their 18th century bigotries.  Corporations steal taxpayers blind while making the ignorant sexually anxious concerning "overbreeding outsiders" (can anyone say "anchor baby"). They appeal to the age old testosterone laden "breeding rights and territory" fears unconsciously nestled in male brains, as well as the old alpha male competitiveness which guards tribal genetics against outsiders.  Since women LIKE new genes in the pool, it is imperative to discredit the segregated minorities, lest they become popular and compete for breeding rights of alpha women. So behavioral psychologists who sold out in the 20th century taught the rich how to most effectively scapegoat minorities and accuse them of "stealing" taxpayer monies; a beautiful shield for the real thieves.  
 

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