Why I wrote on the Q.T.
80% of the thousands of fraud cases that have been filed by citizen have not been adjudicated. Most
of these cases have not been investigated and will bankrupt Medicare and Medicaid soon if not
“fixed”.
To protect HHS and the FDA, the U.S. Government hides prescription drug fraud. 40 years of
continuous government and GAO safety reports warned us that America’s foods and drugs, are
dangerous. No one at the FDA, the Justice Department or involved industries is “willing to tell the
public of the problems, and is both unable and unwilling to correct them.”
Ironically, America’s third leading cause of death is “medical errors” [300,000, compared with
600,000 in both #1 heart disease and now #2 cancers], However, life span is now 90 years or more!
Since the 1976 GAO “Fraud in America” report, fraud has grown exponentially. Fraud is also a main
cause of our $20 trillion National Debt, based on comparisons between agency budgets and fraud
recoveries.
Since 1993 Malcolm Sparrow and all other fraud experts say they do not know exactly how much, but
know that the amount is $600 billion a year, for every year for the last three decades or more in
healthcare alone.
We have the ability to “measure” missing frauds, since we know:
1. The amount of money each of the 73 major agencies spent, including the two largest agencies:
Defense Department and Health and Human Services.
2. Justice Department press releases show all the companies, individuals and amounts recovered.
Fraud Statistics show how little money is recovered in fraud case.
Less than ½% of fraud was recovered. This conclusion is based on dividing the Justice Department
Fraud recoveries by the total amounts spent by the agencies. Additionally, subtracting billions
spent on ineffective federal and state enforcement agents show no net recoveries.
Specific Medicaid Drug Rebate records are reviewed by HHS Medicaid Drug Dispute Coordinators in 10
Regional offices. I sent my $57 million calculated missing rebates to all ten offices. None showed
any interest.
Since 2009, $70 billion in fraud in Medicaid Advantage plans was reported. Additionally, $100
billion is owed to CMS and $27 billion is owed to the states; This is three times larger than all
fraud recoveries of $48 billion in 30 years!
The False Claims Act is now the biggest fraud. the Justice Department defends agencies, and
protects corporations, bureaucrats and powerful interest groups, not taxpayers.
America’s entitlement programs will go bankrupt, if they are not reformed. Unfortunately, it is too
late to fully correct the Fraud that Malcolm Sparrow warned of 20 years ago in Licensed to Steal:
How Fraud Bleeds America’s Health Care System. For example, Medicaid, which is administered through
“block granted” to states. When this occurs, Medicaid fraud will double. Who knows what will happen
to Medicare, if left in the hands of CMS?