Odd Lots How Fraudsters Are Bilking the Government Out of Billions of Dollars
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Nov 18, 2024 
Jetson Leder-Luis, an assistant professor at Boston University and a research fellow at NBER, dives into the murky waters of government fraud. He discusses how schemes like ambulance fraud and identity theft siphon billions from programs like Medicare and Medicaid. The conversation sheds light on the explosion of fraud during the pandemic, particularly in unemployment insurance. Leder-Luis also emphasizes the role of whistleblowers and data analysis in combating these issues, highlighting the urgent need for effective anti-fraud strategies.
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Ambulance Fraud
- Ambulance services, highly reimbursed with low overhead, became a target for fraud.
- Thousands of companies exploited Medicare by billing for unnecessary non-emergency rides, especially for dialysis patients.
Loopholes in Medicare
- Medicare fraud often arises from loopholes designed for a small number of people in need.
- These loopholes can be exploited by bad actors, resulting in billions of dollars in fraudulent spending.
Prior Authorization
- Implement prior authorization policies to prevent unnecessary medical procedures.
- Requiring physician sign-off can significantly reduce fraudulent spending without negative health impacts.