How widespread is Medicare fraud? At 47 billion dollars, the government is now reporting Medicare fraud rates almost three times higher than previously reported. How could Medicare fraud triple in a year? In an effort to be more honest with data collecting, Obama ordered new accounting into effect. It's not clear whether Medicare fraud is actually worsening. Much of the increase in the last year is attributed to a change in the Health and Human Services Department's methodology that imposes stricter documentation requirements and includes more improper payments — part of a data-collection effort being ordered government-wide by President Barack Obama next week to promote honest budgeting and accurate statistics.
And what are some of those increased requirements as they relate to the reporting of Medicare fraud? Yes folks, the legibility of the physician signature. Now that Obama's administration has decided to play games with reporting Medicare and Medicaid fraud, their next step is to reduce the fraud from a make believe 12% to a more palatable 9%. Of course, that still represents a more than doubling of the baseline Medicare fraud.
According to the report, the Bush administration from 2005-2008 reported improper payments of roughly 4 percent in the fee for service program, or about $17 billion total in 2008. Government officials at the time, however, typically did not consider a Medicare payment improper if the medical documentation was incomplete or a doctor's signature was illegible. Since these were flaws that ordinarily bar payment, that methodology drew complaints from government auditors that the figures were understated.
According to the report, the Bush administration from 2005-2008 reported improper payments of roughly 4 percent in the fee for service program, or about $17 billion total in 2008. Government officials at the time, however, typically did not consider a Medicare payment improper if the medical documentation was incomplete or a doctor's signature was illegible. Since these were flaws that ordinarily bar payment, that methodology drew complaints from government auditors that the figures were understated.
I haven't written a legible signature since my first day of medical school. After signing my signature, I would suspect over 100,000 times since I started clinical medicine, my signature is nothing more than a line, a one inch by one inch diagonal line. I simply do not have time to offer the chart a legible signature. Instead I offer the chart my doctor identification number, which is becoming more illegible every time I am forced to duplicate unnecessary documentation. I fear to think what my Medicare documentation will look like as I close in on 200,000 signatures.
Perhaps Obama would like to consider my 45 minutes of intensive care work to be fraud because he couldn't read my signature? Perhaps if he simply asks me if the documentation is mine I would tell him yes. Instead, we have more economic games that won't fix anything.
It appears to me that Medicare is going to save 10 billion dollars by not paying physicians who have illegible signatures. If Medicare and Medicaid stop paying physicians for work done because their signature is illegible, there wouldn't be a doctor in this country that collects money for work provided. Find me a physician with a legible signature and I'll bet you they aren't an MD. Perhaps they are a nurse practitioner in disguise. But give them 40 years to catch up in the signature work load and they too will one day be banned from earning a living by taking care of the old and the poor.
