Undercover Patients


From Daniel Palestrant, Founder & CEO of Sermo
Nearly 1,000 physicians on Sermo responded to a proposal in which the government sends 'undercover patients' to root out physicians fraudulently participating in Medicare and Medicaid. Click below to scroll through the physician comments.

Originally Posted to the Sermo Community
By: An Otolaryngologist on Sermo

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Undercover Patients

Rooting Out Fraud With Undercover Patients

By Peter Landers

Democrats and Republicans generally agree on the need to root out fraud in Medicare and Medicaid, but Sen. Tom Coburn, an Oklahoma Republican, threw out one idea that President Barack Obama hadn't included in his health-care overhaul plan.

Coburn, himself a doctor, said the government should send undercover patients into doctors' offices to probe whether the doctors were willing to break Medicare rules - not unlike mystery shoppers ferreting out bad customer service at stores. Obama said he'd consider putting the proposal into his plan.

Others liked it, too. "I thought your suggestion of undercover patients … is a great idea, and one that we can come together on," said Sen. Charles Schumer, a New York Democrat.

Last year, Coburn proposed using health-care professionals make undercover visits to doctors or hospitals to check out the quality of care.

Medicare and Medicaid fraud includes cases where doctors bill the government for procedures that didn't happen. Estimates of the size of Medicare fraud vary widely. PolitiFact.com looked at the issue last year and threw out one estimate of $13 billion a year.

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