Corporations, as well as state and local government offices often seek private investigators when they need a “new set of eyes” to provide fresh perspective; private citizens rely on companies like MSI Detective Services when matters need to be handled with professional discretion.
In many instances, MSI Detective Services, and other reputable investigators, are sought when cases go cold, or there’s no visible progress; our challenge is to take a case that’s gone cold and heat it up by providing new leads and information.
Medicare’s private investigators took an average of 6-months to refer fraud cases to law enforcement officials.
What follows is a poor example of Private Investigation.
A congressional oversight committee determined that it took private contractors exactly 178 days to pass information off to the government, or enough time for a fraud case that’s burning hot with active leads and information to go stone cold. The time delay decreases the odds of successful of prosecution, costing US taxpayers nearly $800-million in 2007.
Medicare is often abused by those in its care, so the agency’s taken steps to ensure taxpayer dollars aren’t wasted on fraudulent claims; however, due to the number of those using Medicare services, the government has to seek outside contractors to catch cheaters.
In a Medicare study, $835 million in questionable payments were reported to contractors, of which the government recouped a mere $55-million, or about 7% of their disputed amount. In 2009, Medicare overpayments accounted for more than $36 billion according to the Obama administration.
The sour economy has put millions of Americans on Medicare who once had insurance; the President’s hoped-for savings that were to be gained by eliminating waste and fraud to pay for the added burden haven’t materialized.
As CNN wrote, “Medicare’s private eyes don’t seem to be helping much.” In fact, the detective agencies are getting paid while further complicating the problem.
Senate Republicans wonder if the fraud squad is worth it’s input. Republican Senator Charles Grassley, launched an investigation into the contractors to discover why it took so long, and the cost shouldered by taxpayers for ineffective investigations.
There are seven companies Medicare labels “Program Safeguard Contractors” that manage the investigations; some have more than one Medicare contract. Theoretically, the fraud squad employs “proactive” information-gathering techniques utilizing high-tech computers that identify patterns and trends in billings that signal fraudulent health care provider activity. Yet, there’s a huge difference in the number of investigations launched year-over-year. The contractors also vary in case-load: some shoulder less-than ten cases while others work hundreds, and nearly all were unable to identify new fraud trends and patterns.
The contractors don’t account for all Medicare’s losses: when there’s a hint that Medicare might be investigating billings, some providers simply shut down and disappear.
