00 or imprisonment for not more than five years, or both. Analysis of Current Fraud legal analysis of the current fraud committed in the Medicare and Medicaid programs indicates that reforms are in place to detect this fraud, and the involvement of governmental, local and federal police and investigation authorities has increased as well. For example, the National Center Policy for Analysis (2001) reports that 350 FBI agents are now investigating a record 2,300 potentially fraudulent cases in the medical industry. In addition, various government antifraud units are being allowed to tap into the Medicare trust fund for the first time to fund their budgets; $104 million for 2001 and more than $200 million for 2002. As a result of the high volume of Medicare and Medicaid fraud, in the past few years investigators have shifted the emphasis in their investigations from small amount abusers to large medical organizations and institutions, some of which have been known to bill Medicare for patient treatments which were never performed or equipment which was never ordered or used. The health programs most concentrated on by investigators are those that have grown rapidly in the past few years, and Medicare's home healthcare program, where bills have tripled in five years.

Recommendations to prevent the high volume of fraud committed in the Medicare and Medicaid systems include a system of checking to see whether claims are accurate and legitimate, instead of making sure that claims are filed in a standardized process, which is what the government has previously focused on. The Citizens Against Government Waste (CAGW) argues in a recent report that the best way to cut fraud in Medicare is to expose it to the discipline of the market. CAGW recommends replacing the current system with a program to allow beneficiaries to choose from private health insurance plans (National Center for Policy Analysis, 2001). According to this group, competition would tend to drive up the quality of medical care while keeping a lid on costs....

This is because since beneficiaries would be responsible for their own care, they would require more detailed information on the type and quality of care they receive from providers.
Conclusion

Finally, this debate over fraud in the Medicare and Medicaid programs is not a new one, for these programs have often been a target for reformers. However, the prospect of baby boomers gives the argument a greater sense of urgency. In just 10 years, one of the program's two trust funds will be paying out more than it takes in, a direct result of the fraud conducted. Eventually, Medicare could consume as much as 70% of all federal income tax revenue. A USA TODAY analysis found that the nation's hidden debt, a $53 trillion is what federal, state and local governments need immediately, beyond the $3 trillion in taxes collected last year, to repay debts and honor future benefits promised under Medicare, Social Security and government pensions. That already-enormous amount also grows by more than $1 trillion every year. Thus, what is needed is a national single-payer system that would eliminate unnecessary administrative costs, duplication and profits. In many ways, this would be tantamount to extending Medicare and Medicaid to the entire population. A solution to end fraud and this crisis in Medicare must be found before it too late. In conclusion, if nothing is done, we are cheating ourselves and our grandchildren of the health benefits both of us have worked all our lives for.

Bibliography

Bennett, M. (2007). Criminal Prosecutions for Medicare and Medicaid Fraud. Retrieved April 4, 2007, at http://www.aapsonline.org/fraud/fraud.htm.

Antos, Joseph. (1997). The Magnitude of the Financial Crisis in Medicare. 1997

Subcommittee on Health Care, United States Senate.

National Center for Policy Analysis (2001). Fraud in Medicare. Retrieved April 4, 2007, at http://www.ncpa.org/health/pdh5.html.

Serafini, Marilyn. (2004). Health Care - the…