00:59Tonight, a new report on the abuses of Medicare
01:01The devastation in the Pacific Northwest
01:04President Clinton personally delivering promises of aid
01:07In presidential politics, Graham is out
01:10Buchanan is getting a closer look
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01:20in the age of AIDS?
01:23From NBC News
01:25This is NBC Nightly News with Tom Brokaw
01:29Good evening, Medicare and fraud
01:32Tonight there's a stunning report on how Medicare, one of the most important and generous programs in this country, is easy pickings for hospitals, doctors, and healthcare suppliers.
01:42This year, as the Congressional Republicans and the White House are arguing about who's the real champion of Medicare, it is clear that while those political feuds are underway, Medicare is being ripped off. It's massive fraud. Today, a health industry executive went behind a shield to testify on Capitol Hill that Medicare fraud is widespread, especially when it comes to experimental medical devices. And as we learn from NBC's Roger O'Neill tonight, the system is practically custom-built for fraud.
02:12The system is the same.
02:13Thousands of Medicare bills are being paid for fraud.
02:14Thousands of Medicare bills are being paid every day that should not be. For taxpayers, it's a tremendous waste. According to a new government study, as much as $2 million a day. Who's to blame? The General Accounting Office. The GAO says it's sloppy management by the federal agency in charge of Medicare.
02:34This is one of the big granddaddies of fleecing of America.
02:37Republican Christopher Shays of Connecticut. What has to be done, Congressman, to stop it?
02:42It's a simple solution. When the bill comes in, you have a pre-screen, and the pre-screen knocks out all the absurd cases of the sprained ankle where you're doing a chest x-ray. We think we save anywhere from $200 to $500 million just by having this screening process in place.
03:01The abuse is in the numbers, which the GAO says are too high. Last year, there were 9 million echocardiograms billed to Medicare. Pictures of aging hearts cost $851 million. There were 14 million eye exams for such things as cataracts. Cost $686 million. And there were an astounding 34 million chest x-rays for a myriad of old age problems that cost Medicare half a billion dollars.
03:30The GAO says the three procedures are widely overused. The government audit of just a few thousand claims found 5% inaccurate. If they had been checked for medical necessity, more than $113 million in claims would have been rejected. The money saved.
03:48The Federal Health Care Financing Administration, HCTA, is supposed to be Medicare's watchdog. But it farms out to 29 private contractors around the country, mostly insurance companies, the job of paying what's called Medicare Part B claims. That's bills from doctors, outpatient hospital services, and medical equipment. The GAO blames the Medicare waste on the lack of a national strategy from Washington to screen out bad claims.
04:15We don't believe that adopting GAO's recommendations would save money net. It's not rational to apply a single automatic cookie cutter to every claim everywhere in the United States.
04:31But that's what the biggest private insurance companies in the nation are doing. Nancy Boyer, whose Equifax Health Care sells the computer software to check claims, says the government could save too.
04:41Minimally, a billion and a half a year, without ever changing a benefit.
04:47And the savings would pay back the $20 million cost to the system in just 10 working days. While most medical tests to the nation's elderly are legitimate, critics charge without more aggressive screening of all Medicare bills.
05:01This fleecing of America will continue to waste hundreds of millions of taxpayer dollars every year. Roger O'Neill, NBC News, Denver.
05:11Still to come here on NBC Nightly News tonight, romance in the age of AIDS.
05:16You need to protect yourself from sexually transmitted diseases, including HIV and AIDS.
05:22How has it changed us? And love, American style, some surprising answers in depth tonight.
05:27And up next, deep pockets, the president's trip to the flooded Northwest.
05:30On the Selina Scott Show tomorrow night, I'm joined by the award-winning journalist Mike Nicholson to talk about Bosnia.
05:41I'll be finding out about the revolution in digital home video cameras, meeting Petri Hoskin, who broadcasts from and to War Zones,
05:48and hearing from Elkie Brooks, one of the most consistently successful British female singers ever.
05:54Join me at 7.30 tomorrow and every night on NBC Super Channel.
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