Mitch Keamy is an anesthesiologist in Las Vegas Nevada
Andy Kofke is a Professor of Neuro-anesthesiology and Critical Care at the University of Pennslvania
Mike O'Connor is Professor of Anesthesiology and Critical Care at the University of Chicago
Rob Dean is a cardiac anesthesiologist in Grand Rapids Michigan, with extensive experience in O.R. administration.
First, this news item, from the BBC:
http://www.bbc.co.uk/news/world-us-canada-14831292
http://www.reuters.com/article/2011/09/07/us-usa-health-fraud-idUSTRE78669920110907?feedType=RSS&feedName=domesticNews
http://www.dailynews.com/health/ci_18848233
91 people and around $300 million in fraud. Once again, Miami seems to be epicenter of the problem, with about half of the arrests taking place there. If the news items are correct, these allegations represent outright fraud and theft of money, not disputes over disparities between levels of service provided and billed for. The former is uncontroversial, the later is and will continue to be a huge headache for honest practitioners.
In this instance, there were arrests in the Chicago area:
http://www.wlsam.com/Article.asp?id=2280751&spid=
Please note: bills were apparently paid for services rendered to dead people. This is not quite as odious as it sounds, as the modern world of medical billing can create a substantial delay between the time a service is provided and the bill for it is generated.
How does this happen? Well, this story is informative:
http://finance.yahoo.com/news/Report-Systems-to-catch-apf-1125498258.html?x=0&.v=1&.pf=retirement&mod=pf-retirement
So, a total of 41 people are tasked with ferreting out something like 60-90 billion dollars in fraud. First, it is hard for me to imagine that there is that much fraud out there. Suppose it was only $6 billion. Suppose you had your full complement of 600 investigators. That's $10 million in fraud per investigator per year - there is at least the potential for a huge return on your investment. Only the Feds could underinvest on this scale.
And for those of you who are interested in the NHS IT saga from across the pond, I point out this news item:
http://www.bbc.co.uk/news/health-14378346
The article is replete with statements about the substantial sums that have already been spent, and the the real-world frustrations to implementing this apparently 'good' idea. Outsiders have a hard time imagining what the problem. Anyone with any real familiarity with these systems has a hard time imagining any other outcome.