Q: Why has this "Dr." Qamar billed and
abused our tax-funded Medicare system like a charlatan?
A: Because he COULD.
CMS has known for a long time what this guy was/is doing. And there are many other crooks billing Medicare just like he does across across the country.
The magnitude of this abuse of taxpayer-funded public health insurance is so huge that to me, it is absurd to want this same monstrous type of system across the board for
everyone to be under a government single payer system!
Consider:
"The true annual cost of fraud and abuse in health care is not known. In fiscal year 2011 Medicare spent $565 billion on behalf of its 48.7 million beneficiaries, while federal and state Medicaid agencies served 70 million people at a combined cost of $428 billion. CMS estimated that in fiscal year 2010 these two programs made more than $65 billion in "improper federal payments," defined as payments that should not have been made or were made in an incorrect amount. Adding in improper payments made by state Medicaid programs boosts the total by about $10 billion annually.
UNDERSTANDING THE PROBLEM: CMS's estimate of improper payments, which relies on random samples of claims data, is widely thought to understate the true size of the problem of fraud and abuse. In an April 2012 study former CMS administrator Donald M. Berwick and RAND Corporation analyst Andrew D. Hackbarth estimated that fraud and abuse added as much as $98 billion to Medicare and Medicaid spending in 2011.
For many years, the Government Accountability Office (GAO), the investigative arm of Congress, has designated Medicare and Medicaid as being at "high risk" for fraud, abuse, and improper payments. Both programs were designed to enroll "any willing provider" and to reimburse claims quickly for services provided.
The programs today handle an enormous volume of transactions, making it easier for dubious claims to escape detection. Every business day, for example, Medicare administrative contractors process about 4.5 million claims from 1.5 million providers. Every month, they process 30,000 enrollment applications from health care providers and suppliers of medical equipment.
The emphasis on rapid payment, as opposed to identifying and rooting out false or inflated claims, makes both programs susceptible to fraud. Taking advantage of this weakness, for example, Eastern European crime syndicates have lately become prevalent players in Medicare fraud, specializing in stealing the identifies of Medicare and Medicaid beneficiaries, and then billing the programs for treatments that didn't take place at clinics that don't exist.
The magnitude of potential wrongdoing is such that resource-strapped federal prosecutors have adopted an unofficial threshold that requires that alleged crimes be worth at least $500,000 and be clear cut enough to make conviction a near certainty before they will take up a case. That leaves a lot of room for marginal operators to game the system for many multiples of much smaller sums….."
Health Policy Briefs
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