PMD: One Often Forgotten Cause of Healthcare Fraud...

[FPMD: Welcome to another installment of Future Proof posts on Physician's Money Digest (PMD).  Today we will take a detour from personal finance and talk about finance on a grander scale.  Here is one often forgotten cause of healthcare fraud.  As usual, read the full post at PMD.  An excerpt is provided below.]

With an estimated 12% of Medicare and 10% of Medicaid payments lost to fraud and other improper payments in 2015, it is no surprise that battling healthcare fraud is a high priority on the government's checklist.  In June of 2016, the Justice Department announced the largest healthcare fraud takedown in history with charges against 301 individuals totaling $900 million in false billing.  Let's talk about one rampant cause of healthcare fraud that doesn't get the limelight.

Big cheat vs little cheats

In an interview with NPR, author and professor of psychology and behavioral economics Dan Ariely discusses his experiments with over 30,000 people and what he learned about how we lie to everyone - especially ourselves.  Here is one excerpt from the interview that I found particularly interesting:

"Across all of our experiments, we've tested maybe 30,000 people, and we had a dozen or so bad apples and they stole about $150 from us. And we had about 18,000 little rotten apples, each of them just stole a couple of dollars, but together it was $36,000. And if you think about it, I think it's actually a good reflection of what happens in society." 

It is easy to identify the "big cheats" in healthcare fraud.  For example, out of the 301 individuals charged by the Justice Department in June, Houston area family physician Dr. John Ramirez is accused of billing medicare to the tune of $18 million for home health visits that were either unnecessary or simply not provided.

But who are the little cheats?

Read more at PMD


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Future Proof, MD

Dr. Bo Liu is an aspiring radiologist-in-training and the founder and editor of the White Coat Money Blog.  He has an interest in interventional radiology and helping his medical colleagues get ahead in this mad world of medicine and money.  When he's not crushing the list at the PACS station or typing up your next favorite blog post, you can usually find him at the local badminton club, movie theater or the most recently opened restaurant.