How Medicare And Medicaid Fraud Became A $100B Problem In The U.S.

In an exclusive investigation, CNBC takes you inside how fraudsters are stealing Medicare and Medicaid funds through a wide variety of criminal operations. Special agents from the Office of Inspector General (OIG) show us how brazen these schemes have gotten from burying stolen Medicare funds in PVC pipes under a home to setting up a fraudulent business in the same building as the OIG. A convicted fraudster who served time for health care-related crimes says it’s “very easy” to make millions and stay under law enforcement’s radar because the fraud is so rampant. In a Miami shopping mall that’s been the targeted of OIG investigations, CNBC finds a medical supply company that’s billed Medicare more than $2 million in a small glass-enclosed office with someone sitting at desk, which investigators say is typical about fraudulent operations are set up. Annual Medicare and Medicaid fraud is estimated at more than $100 billion.

Senior Investigative Producer: Scott Zamost
Correspondent: Contessa Brewer
Editor: Steve Banton
Photographers: Oscar Molina, Marco Mastrorilli
Audio: Juan Merlo
Graphics: Michael Schwartz

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How Medicare And Medicaid Fraud Became A $100B Problem In The U.S.

[coreyashley]

I'm a tax paying veteran. This country allows the working class, tax paying citizens to be victims of grand disservice and unethical theft. While many of these people do get away with this, it's terrible and embarrassing to know that the rest of us are always on the hook for medical payments.

[yuglobalcitizen]

Yet I had to pay $2700 out of pocket due to high deductible insurance provided by my company when I fractured my wrist then visited ER, the Dr wrapped my wrist and gave me pain killer. I simply not qualified for Medicaid because I make"too much" money as regular blue collar worker. I didn't wanton see Dr last week when I had sore throat and coughing my lungs out because it will cost me over a hundred out of pocket. And I have friend who is visiting nurse told me he went to see this patient who has Medicaid yet lives in penthouse in a building of Manhattan, the living room so huge that they put a grand piano in the center. How the heck people like that can get free medical and I have to avoid Dr after I pay thousands a year for medical insurance? What's wrong of this country?

[TheChrisgralnic]

We have to start treating fraud with more severe consequences

[ronlaugsburger]

The people who really suffer are the people that really need good medical equipment, instead they get denied or are given the cheapest . The fraud penalties need to be increased and those in the supply chain.

[Bat_Boy]

As a person who has used social services funded by tax payers, this makes my blood boil too. At sometime in your life, you might legitimately, absolutely NEED these services…and here are people stealing that tax payer money. 😡

[velocityhawk]

What really sucks is these thieves are making it difficult for people who actually need it.

[sarahwilliams]

How is it so "easy it's easy, easy" for them to just take it, but damn near impossible for patients to get fully covered without going broke themselves?

[christopherreed]

I am currently doing my MBA in Healthcare Management at Temple University. In one of my classes, we discussed about Healthcare fraud and it became apparent that MEDICARE and MEDICAID were VERY prone to fraud.

[blahblahblah]

Wait, why are doctors allowed to be selling patient info to ANYONE?! I'd be investigating that.

[luisurena]

I used to work for an insurance company in the medicare supplement/medicare advantage plans division and almost all claims calls from "providers" were for dme... and a lot of times i got calls from patients who got billed for dme that they didn't even need or got in the first place, this explains a lot.

[SunshineKK]

Medicare should create a department where their representatives have to go out to the physical DME location to check it out before payment is rendered.

[TheUnitedDrills]

I Seriously Laughed Out Loud When She Called & The Phone At The Desk Rang! ☎️😂

[mahakeem]

Man they should get life in prison 12 years is just a bare minimum.

[RVNBUDS]

Finally, it's being reported..the doctors that do this is unreal

[Pterygotus]

This right here is why the government needs to nationalize healthcare. Anytime you get private companies able to take government money for services, you get a high potential for fraud or abuse.

[daymajor]

GOP Senator Rick Scott should be in this video. He was CEO of Columbia/HCA when they defrauded Medicare, Medicaid etc. They were fined $1.7billion but Rick Scott left with $300 million in stock, a $5.1 million severance, and a $950, 000-per-year consulting contract for five years.

[ZAGIDI]

Only sentence to 12, 5 years? Seriously? And someone will be sentenced for more than 12.5 years for less than $50. SMH . This judicial system is discriminatory. What a shame

[itstayayg]

Scamming is up there with murder. Sucks trust and integrity out of everything and destroys everything.

[thelostcosmonaut]

Don't forget private ambulance companies and their rackets. They are one of the worst perpetrators of this and have the nerve to pay their employees next to nothing.

[harryo]

why dont they go after the doctors who are selling the patients