Tuesday, March 7, 2017

Medicare and Medicaid Wasting Money

The federal government seems to have some creative ways to waste taxpayer dollars. If only they would use that talent to find ways to solve problems rather than ignore them or worse yet, cover them up.
Don't hold your breath.

Medicare and Medicaid Reimbursements
When a Medicare or Medicaid patient goes to a doctor or hospital, a claim is filed for reimbursement and payment is made by the Centers for Medicare and Medicaid (CMS) directly to the doctor or hospital. That's not hard to understand, not even for bureaucrats. But if a claim is denied by CMS the hospital has the right to appeal. That seems fair.

So What's the Problem?
The CMS is disorganized, backlogged so far they can't even see daylight, and dare I say incompetent. That's the problem. Rather than fixing the problem, the CMS agrees to partially pay hospitals who appeal a claim that has been denied. 
In 2015 CMS settled 300,000 claims that had already been reviewed, found to be 'medically unnecessary' and denied...twice.
CMS pays these claims from the Medicare Trust Fund without congressional approval.



Hey Congress, wake up and smell the money burning!

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