Maximizing' Medicare fraud

Medicare spends $500 billion a year on the elderly. Tens of thousands of health care providers want a piece of it. To get the largest slice possible, many hospitals hire consultants to help them come up with new ways to makes claims on Medicare funds.

Unfortunately, some consultants suggest ways to cheat. Knowing that Medicare only audits 2 percent of the requests for Medicare funds, they do the same thing unscrupulous tax consultants do – they tell their clients what amount of deductions they can claim without risk of audit and even create for them phony receipts to increase the amount of deductions to claim.

While working in the Fraud Division of the Department of Justice, I became aware of seminars held by corrupt health care consultants drawing in new clients with the promise of "maximizing " Medicare funds. They were simply hired guns willing to teach hospitals how to cheat.

Recently, the Department of Justice caught yet another consulting firm helping others ripoff Medicare . The government alleged that Besler & Company, located in Newark, N.J., counseled hospitals to improperly enhance its Medicare claims. The firm tried exploiting a loophole in the system, but needed to fudge the facts to meet the exception. In the end, it got caught and had to pay $3 million to settle fraud allegations.

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