The Fraud In Your Health Plan is Staggering

BenefitsPRO just published my latest.

The perplexing maze of the U.S. health insurance system is riddled with fraud, a lurking demon that clandestinely drains a staggering proportion of health care expenditure. One-third of every dollar circulating in the health care system — totaling over $1 trillion — is squandered on dubious services, lost to fraud, or otherwise misused.

Taking a casual look at media coverage on the subject, it becomes apparent that there are numerous stories highlighting the extensive waste and fraud present in Medicare and Medicaid, while comparatively limited attention is given to employer plans. In 2019, private insurance expenditure skyrocketed to a whopping?$1.2 trillion, yet no systematic tracking exists to monitor funds diverted by fraud. Expert estimates suggest that up to a?tenth?of all health care spending might be swallowed by fraudulent operations. The insurance industry insists it’s vigilantly safeguarding these funds, but the unnerving reality reveals a different story — fraudsters find easy loopholes in this system, and persuading insurers to clamp down on them seems a Sisyphean task.

Full story here: https://www.benefitspro.com/2023/06/15/unmasking-the-health-care-fraud-epidemic-3-steps-to-a-revolution/