As mentioned before, it is not in the interest of the RAC’s to report a physician for fraud.


The RAC’s get ZERO if they report for fraud…BUT if they retract funds paid to a Doc, they then get a percentage of that take.

Make sense?

How about this:

As report in USA Today on 9 Aug 2010, the contractors that are hired to investigate and report fraud are slow to do anything.

Hmm, why might this be?

The contractors that are hired to investigate Medicare fraud are called “Program Safeguard Contractors”.

These PSC’s are hired to research fraud, then report the fraud (if it exists) to law enforcement.

Apparently it takes an average of 178 day for the PSC’s to refer fraud cases.

The amount of time tends to allow the trail to go cold.

As reported:

Out of $834 million in questionable Medicare payments identified by private contractors in 2007, the federal government was only able to recover some $55 million, or about 7% of the funds.

The hoopla is centered around this – the federal government has to find a way to pay for what they are trying to provide.

This means fun and exciting things like:

  • 1099’s for any purchase of a product or server greater than $600…for everyone!
  • more fraud investigations
  • more RAC audits
  • more of anything that can increase the revenue brought into the federal government

Watch out…the Fed’s aren’t just coming after individuals, but all you private practice Docs out there are the prey also.

Do what you can to protect yourself.


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