Groups Handling Medicare Payments May Have Direct Relationships, Investigation Ongoing

Government officials will investigate potential Medicare fraud

Senators explained that they believe some companies used to assist in hiring and paying medical claims with Medicare, may have significant interest conflicts.

Various companies have relationships that are a reason for officials to be concerned, lawmakers explain.

Government officials have analyzed contractors hired to assist in Medicare billing. The contractors are responsible for billing Medicare after a patient has been treated.

Officials discovered that some contractual groups hired by companies were actually subsidiaries of the hiring company, showing a direct relationship that would be financially benefiting from the Medicare claims payments from the government.

The government agency responsible for overseeing Medicare is the Centers for Medicare and Medicaid Services (CMS). As a federal program, Medicare is responsible for insuring the health of close to 50 million American individuals who are either disabled or elderly.

In most cases, CMS tries to use private, external companies to perform billing and clerical tasks for payment and health coverage claims.

Investigations will take place as to whether or not there is anything illegal occurring, as officials hope tax dollars not being wasted by these organizations.