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Tags: medicare | covid | 19 | fraud | pandemic | funding

Fraud, Overspending Lead to $2 Billion Spent on COVID-19 Testing

By    |   Friday, 30 December 2022 05:00 PM EST

Medicare spent $2 billion on COVID-19 testing this year through Oct. 31, an amount expected to surpass 2021 as experts say fraud and overspending have contributed to the spike.

CareSet provided the $2 billion number to ProPublica, which compared it to Department of Health and Human Services data from the last two years. In 2021, $2 billion was spent on COVID-19 testing, with a total of $1.5 billion in 2020.

According to experts who talked to ProPublica, the federal money sent to kick off testing for healthcare providers and laboratories is not subject to some of the same regulatory constraints as other tests covered by Medicare.

The government's financial incentives for the program included extended Medicare reimbursement and access to a fund for testing the uninsured. Those measures drew in fraudsters, price-gougers, and the inexperienced.

"It was an unprecedented wave of fraud," said HHS official Michael Cohen, an operations officer for the department's inspector general. The most common crime, Cohen said, was identity theft — stealing customer information and then billing for unnecessary services.

"They would take it all. 'We need your Medicare number. We need your Social Security number. Oh, we need credit card information.' People were giving up just tons of information because people were understandably clamoring for tests," he explained.

Earlier this month, the HHS Office of Inspector General released a report claiming 378 labs billed Medicare for additional tests at "questionably high levels" after testing individuals for COVID-19.

It comes after the Justice Department revealed in April it would charge 21 individuals in eight states who allegedly submitted more than $149 million in COVID-19 false billings to federal programs.

"The scale and complexity of the schemes prosecuted today illustrates the success of our unprecedented interagency effort to quickly investigate and prosecute those who abuse our critical healthcare programs," the director for COVID-19 fraud enforcement, Kevin Chambers, said at the time.

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Medicare spent $2 billion on COVID-19 testing this year through Oct. 31, an amount expected to surpass 2021 as experts say fraud and overspending have contributed to the spike.CareSet provided the $2 billion number to ProPublica, which compared it to Department of Health ...
medicare, covid, 19, fraud, pandemic, funding
314
2022-00-30
Friday, 30 December 2022 05:00 PM
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