Statement of Walter J. McDonald, MD, FACP
Executive Vice President
American College of Physicians - American Society of Internal Medicine on the National Medicare Anti-Fraud and Abuse Outreach Campaign
February 23, 1999
CONTACT: Jack Pope, Public Affairs Director, Washington Office, 202/261-4556
The members of the American College of Physicians - American Society of Internal Medicine (ACP-ASIM) strongly support government efforts to remove fraudulent practices from the Medicare program. Likewise, we believe that health care consumers have a positive role to play in terms of understanding the costs of their care and identifying blatant cases of fraud and abuse.
A misinformed consumer, however, is as vulnerable to harm as an uninformed consumer. For that reason, we are concerned about some aspects of a joint project by the American Association of Retired Persons (AARP) and the U.S. Department of Health and Human Services (HHS) that encourages Medicare beneficiaries to review their bills to help detect fraud.
The AARP has circulated a pamphlet for this initiative that incorrectly states that "as much as 10 percent of Medicare charges are fraudulent." In reality, the HHS Office of the Inspector General reports a much lower percentage of improper payments. A recent report states that these so-called improper payments "could range from inadvertent mistakes to outright fraud and abuse," and adds that "the portion of the error rate attributable to fraud could not be quantified."
Little will be gained by suggesting to patients that their chances of detecting fraud are high. The truth is that most of what the government terms "waste, fraud and abuse" results from simple billing errors and the problems inherent in complying with Medicare's more than 100,000 pages of rules and supporting documents. ACP-ASIM is working with the HHS to reduce such errors and has developed a working paper on the subject titled Reducing Waste, Fraud and Abuse Without Increasing the Hassle Factor for Physicians and Their Patients.
Inevitably, the AARP/HHS campaign means doctors will have to spend more time answering billing questions and less time providing care to their patients. We should all work together to focus attention on areas where problems truly exist.
ACP-ASIM is committed to working with patients and the federal government to eliminate genuine fraud from the Medicare program. Encouraging a vigilante mentality based on misleading statistics does nothing to advance this goal.