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Our top story tonight tax Payer paid drug abuse and fraud a shocking report revealing -- clear case.
Dietitians and other professionals writing out millions of dollars worth the prescription drugs without federal authority -- these out and Medicare is picking up attack.
But more on this doctor Scott -- former policy advisor for the Centers for Medicare & Medicaid Services -- -- -- -- this important department of health and human service.
It is -- -- hasn't happened -- some of this is out right fraud some of these of people who have licensed in the particular state to prescribing not licensed under the federal scheme.
Proponents of government run health care talk about how cheap it is to administer the Medicare program now I think we know why they don't -- do -- utilization review.
In other words there's no oversight is no oversight they're not -- if you look at a private health plan they -- literally thousands of providers to overlook the claims to see what's being done.
If you look at Medicare they don't play providers to do that what they do is they they have people -- requirements basically they required documentation know what the documents.
But if you -- -- cheat the system you're gonna fake documentation.
-- some -- -- anecdotes are jaw dropping word in this report.
A Florida massage therapist broke more than 38700.
Prescriptions for drugs in 2009.
How -- didn't raise any red flags back in 2009.
Policy it's not that hard to cheat the system if you're willing to break the law -- I think there's a public health.
Aspects of this is well because some of these prescriptions are for dangerous drugs that should be prescribed to these senior citizens.
So could you boil it down you agreed that this is essentially tax Payer funded drug abuse.
That's exactly what it is is fraud and abuse and a program okay so this report by the department health and human services again -- in 2009.
Four years later has compounded it's got to be worse correct we agree.
But pro who's gotten bigger so we assume it's it's gotten compounded we're doing more right now to look at these things is more focus on the fraud and abuse in the program.
But it's easy this is a remote bureaucracy this is right out of Washington health care of the local endeavor this is what happens when you run vast bureaucracies from a remote location.
You know people criticize a large government and these entitlements are so desperate for reform do you believe Scott.
These entitlement programs Medicare Medicaid can be reforms and prevents criticism from being part of the big government.
Well in this case part of the bonus is also on the part.
Did their hands are tied behind their back to some degree they're going to be freed up to go after some of this waste and abuse right now.
But many cases -- -- generic drugs are cheap drugs that it really there's really no one looking at what's happening with the cheap drugs and these are expensive drugs and be close of.
Focus on it interesting so the other element to this report shows that Social Security.
-- providing disability benefits to people many of whom were denied benefits on the state level.
That's right this is become a vast business right now trying to when you get denied at a local level for his Social Security.
Disability benefits appealing to an administrative law judges about 15100 of them in a country.
And about 50% of cases they'll build a -- the benefits.
Has about 200 judges that affirmed the benefits to 75% -- -- -- -- lawyers and make a business out of going before these judges.
-- -- and there's no final left and this is also part of the problem so people get their benefits.
And then we see the video and there have been numerous news reports right showing people who apparently -- back injuries were playing basketball.
That's right again there's supposed to be review of the program to make sure people still have the disability and deserve their benefits that's not getting done.
People qualified to have a disability that can keep that's gonna keep them unemployed for more than a year for at least a year in some cases these disabilities resolved but there's no follow up.
All right thank you so much Scott got -- the former center for Medicaid.
And Medicare services policy advisor things -- thanks for sharing your expertise with us.
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