Health Care Fraud: In The Billions, But How Many?


Estimates of the amount lost annually in the U.S. from medical fraud range from from $60 to $600 billion, says National Public Radio. Most commonly, criminals get a list of patients’ names, then create fictitious doctors. They send bills to Medicare or Medicaid or health insurers for services supposedly rendered to these patients. In “rent-a-patient” schemes, recruiters find people with health insurance willing to get care they don’t need, in exchange for cash or cosmetic surgery.

In May, the Obama administration announced a new task force made up of officials from the Department of Justice and the Department of Health and Human Services to work on health care fraud. The big question is, how much money could be saved by eliminating fraud? It’s a lot, says Malcolm Sparrow of Harvard University. “We know the order of magnitude,” he says. “That’s to be measured in hundreds of billions of dollars.” But he can’t say if it’s $100 billion or $500 billion or $600 billion.

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