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Fraud and Abuse in Federal Programs. Print. The federal government is a vast money transfer machine. It spends hundreds of billions of taxpayer dollars each year on subsidy programs—from the massive Medicare to hundreds of more obscure programs that most people have never heard of. There are more than 1,8.
With such a huge array of handouts, the federal budget has become victim to large- scale fraud and abuse—that is, people taking government benefits to which they are not entitled. Just about every subsidy program suffers from fraud and abuse, and we illustrate the problems here with discussions of Medicare, Medicaid, housing programs, student aid, and farm subsidies. Losses to federal taxpayers from fraud, abuse, and other types of improper payments are in the ballpark of $1. There have been efforts to reduce improper payments, but the abuse of federal programs continues at high levels. We think that federal subsidy programs should be cut because they harm the economy and are unfair to taxpayers. But endemic fraud and abuse provides an additional reason to pursue cuts and terminations to many federal programs. As broad- based government programs, the massive size of Medicare and Medicaid makes them very difficult to police. Medicare, for example, processes 1. Let's look first at the fraud and abuse problems in Medicare. The Government Accountability Office estimates that there are about $1. Medicare payments each year, including fraudulent and erroneous overpayments to health care providers. That figure does not include the huge new prescription drug benefit, which is thought to be highly susceptible to abuse. Other estimates of improper Medicare payments are higher. Malcolm Sparrow of Harvard University, a top specialist in health care fraud, argues that estimates by federal auditors do not measure all types of fraud. He believes that as much as 2. Medicare. 5. Sparrow says that criminals can rip off federal health care programs simply by carefully filling out and submitting the proper forms, and then the . A high- school dropout with a laptop computer was able to single- handedly cheat Medicare out of $1. There are many ways that Medicare gets ripped off: . Then the doctors receive kickbacks from wheelchair supply companies or other operatives. A 2. 00. 8 report by Senate investigators found that 3. The agriculture slump is getting so bad in the U.S. Bill Would Send More Subsidies to Farms. The CBO estimates total government aid to farmers will grow to $23.9 billion in 2017. Included in these services are programs like the Market Bulletin. Another area of fraud is Medicare's home health care benefits. Medicare pays for home visits by health professionals under certain limited conditions, but patients find ways to illegally get around those limits. In addition, criminal gangs have simply looted this program by submitting false claims. The costs of Medicare home health care coverage soared 4. Auditors have been concerned about fraud in home health care for years, but the problem never seems to get solved. The bigger Medicare gets, the more fraud there is. The newest subsidy—the $6. A physicians' publication noted that the benefit was . It's also ripe with opportunities for the dishonest and fraught with traps for the unwary. The GAO puts the cost of improper Medicaid payments at $3. But if improper payments are 2. Malcolm Sparrow thinks might be the case, that would be a $6. New York's Medicaid is especially fraud- ridden. The former chief investigator of the state's Medicaid fraud office believes that about 1. Medicaid budget is consumed by pure fraud, while another 2. A 2. 00. 5 investigation by the New York Times found remarkably brazen examples of fraud and abuse in New York's Medicaid. The article noted that the program has . She even had the chutzpah to make claims for 9. Medicaid's subsidies for handicapped transportation are widely abused. The program pays $5. Schools across the state charged Medicaid more than $1 billion for unneeded or unprovided special education activities as a way to bilk the state out of additional Medicaid grant money. Criminal gangs diverted Medicaid- covered muscle- building drugs that were intended for AIDS patients to bodybuilders. Similar schemes to bilk federal health programs are routinely uncovered across the nation. Federal investigators say that they play . In one recent case, the University of Medicine and Dentistry of New Jersey double- billed Medicaid repeatedly over the years by directly submitting claims for outpatient physician services, even as doctors working in the hospital's outpatient centers were submitting their own claims for exactly the same procedures. Another area of fraud is Medicaid's long- term care benefits, which cover the costs of nursing homes and home care for the elderly poor. Medicaid pays about half of the costs of all long- term care in the nation. The program has complex rules for eligibility related to one's income and financial assets. But nursing homes are expensive, and so the program creates incentives for middle- and higher- income families to try and qualify for it. Indeed, an industry of financial consultants helps seniors hide their income and assets so that they become eligible. This sort of abuse costs taxpayers about one- fifth of the program's cost, or about $1. One reason why Medicaid has high levels of fraud is that it is an open- ended . The states administer the program and decide how much to spend, but the federal government pays more than half of the costs. That creates a disincentive for state officials to worry too much about fraud and abuse. Indeed, state governments themselves have a history of abusing Medicaid by creating schemes to improperly boost their receipt of federal matching dollars. The Washington Post rightly called these state schemes a . That would immediately give states a big incentive to cut all types of waste, fraud, and abuse. In sum, the magnitude and complexity of federal health programs results in a huge and ongoing waste of taxpayer funds. Sparrow argues that health care fraud and abuse . More likely two or three. Possibly four or five. In 1. 97. 1, Time discussed a scandal at the Federal Housing Administration in which . The magazine concluded that . The largest share of HUD's budget goes toward rental subsidies for low- income tenants. There are about $1 billion in erroneous and fraudulent overpayments of these subsidies each year, according to the GAO. Tenants make false claims to gain eligibility for rental subsidies, and local public housing authorities (PHAs) have often abused these federal monies. Public housing is another area of abuse. HUD provides about $8 billion a year to more than 2,0. PHAs. PHAs are infamous for their mismanagement, corruption, and wasteful spending. HUD is supposed to oversee the PHAs, but its efforts leave a lot to be desired. The Miami Herald won a Pulitzer Prize in 2. Miami- Dade's PHA—a PHA that had passed HUD audits. Here are some of the abuses uncovered by the Herald: 3. The PHA gave developers and nonprofit groups with political connections millions of dollars to build affordable housing, but they ended up building shoddy houses or no houses at all. HUD gave the PHA $3. Six years later, half the money was gone, and only three houses had been built. The agency frittered away its money on staff salaries and consultants. Instead of selling new houses to low- income buyers, the PHA allowed developers to make sales to wealthy investors who then . For decades, PHAs across the nation have been mishandling taxpayer money. Unfortunately, HUD rarely cuts off the mismanaged PHAs. A USA Today article counted 6. PHAs that received funding from the 2. Another area of ongoing abuse is the Federal Housing Administration's mortgage loan insurance system. Buyers abuse the system by obtaining loans under false pretenses, and lenders abuse the system by issuing loans for more than properties are worth. These sorts of fraud increase the risks of default, which ultimately costs the taxpayers. As an example, a New Jersey underwriter routinely falsified employment verification documents to obtain FHA- insured mortgages for unqualified borrowers, which resulted in $1. In sum, programs for public housing, rental assistance, and housing finance have been magnets for fraud and abuse for decades. The Department of Housing and Urban Development ought to be dismantled, and its poor record on controlling fraud and abuse is one good reason why. The three main culprits are students and their families, educational institutions, and lending companies. It is difficult to stop the cheating in student loan programs because they . With the Pell college grant program, for example, this type of fraud costs taxpayers hundreds of millions of dollars per year. Another abuse is that many students simply decide not to pay back their federal student loans. In 2. 00. 1, the GAO found that there were more than $2. Educational institutions often pilfer money meant for students. Under most student loan and grant programs, federal aid is sent to thousands of educational institutions, which are supposed to distribute it to eligible students. However, that distribution system has attracted swarms of shady schools and administrators over the decades that pocket the federal money at the expense of students and taxpayers. A string of scandals in the early 1. One scandal regarded the trade school American Career Training Corporation in Florida. The school recruited new . Another scheme involved 2. Jewish schools in New York State that used millions of dollars in Pell grants to line their pockets while spending little on education. Yet another scandal at the time involved owners of Advanced Business College in Puerto Rico, who used Pell grants to buy $3 million worth of sports cars and real estate for themselves. A Senate investigation in 1. In 1. 99. 4, the department admitted that it was losing a staggering $3 billion or more annually to waste, fraud, and loan defaults. Education Secretary Richard Riley called the department's oversight . In 2. 00. 2, a GAO investigation revealed how easy it was to scam the student loan programs by simply sending in applications under fake student names. Federal Benefit and Assistance Programs. August 2. 3, 2. 01. However, there are federal government benefit programs available to help with many other life situations and needs. Here you will find profiles, including basic eligibility criteria and contact information for 1. |
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