1. El Fraude Proviene de Proveedores y Corporaciones.
La abrumadora mayoría de las menciones en el archivo indican que el fraude en Medicaid es perpetrado por entidades que facturan al sistema, como hospitales, consultorios médicos, farmacias y compañías de seguros, a través de reclamos falsos o sobrecargos.
- Fun fact medicaid fraud is not with the beneficiaries, but with crooked providers who submit false claims, stealing millions from the taxpayers.
- The vast majority of it is committed by providers like hospitals, nursing homes and pharmacies.
- The real problem is over 90 of medicaid fraud is committed by providers, not patients. Hospitals, clinics, and pharmaceutical companies are the ones overbilling, upcoding, and exploiting the system for profit.
- Medicaid waste, fraud and abuse is a top-down, not bottom-up issue. Insurance cos, crooked providers, etc.
2. Los Beneficiarios No Reciben Dinero.
Un punto recurrente es que los beneficiarios de Medicaid no reciben pagos directos en efectivo, sino servicios médicos. Esto hace que sea virtualmente imposible para ellos cometer fraudes a gran escala, ya que el dinero se dirige a los proveedores.
- Medicaid does not pay people, they pay insurance companies or doctors. If there is fraud, then why are regular people the target.
- I still dont understand the concept of medicaid fraud by participants. They commit fraud in order to gain. Healthcare?
- Plus they dont receive anything! medicaid directly pays the healthcare provider doctor, hospital.
- So many people think medicaid is a check you get and cash. Like poor folks are scheduling fake procedures and pocketing the money. Recipients never see a dime! providers and corporations are the thieves.
3. Cifras y Escala del Fraude.
Las estadísticas y los informes de auditoría indican que el fraude cometido por beneficiarios es insignificante, mientras que el fraude corporativo se mide en miles de millones. Gran parte de los "pagos indebidos" se deben a errores administrativos, no a engaños por parte de los pacientes.
- Medicaid fraud occurs in less than 2 of recipients. Incorrect payments has been around 5, but thats the governments mistake, not the people, and those two scenarios arent the same.
- Medicaid 2023 facts. 858 billion spent, 1.2 billion in fraud found. 70 of fraud committed by docs, insurance companies and hospitals. The fraud committed by individuals .04 or 4 cents for every 100.
- The vast majority of improper medicaid payments stem from documentation mistakes and do not fit the definition of waste, fraud, or abuse.
- The perpetrator of the largest medicaid fraud in history is for people using their position in office to profit.
4. Crítica a la Retórica Política.
Existe una fuerte crítica a los políticos que utilizan la excusa del "fraude, despilfarro y abuso" para justificar recortes masivos a Medicaid, argumentando que estas acciones castigan a los pacientes vulnerables en lugar de abordar a los verdaderos criminales corporativos.
- Politicians say theyre fighting medicaid fraud. Their plan punishes patients, not the providers who steal millions.
- The new spin is theyre not cutting medicaid, theyre reducing fraud and waste. The ever accommodating deflection.
- The new welfare queen has morphed into a 35 year old dude who plays video games while on medicaid.
- The only waste, fraud and abuse are folks like rich scott and all those florida companies defrauding medicaid and medicare.