US targets corporate executives for Medicare fraud – what about Canada?

Medicare fraud in the United States is estimated to be as high as $60 billion per year. Now Washington is stepping up enforcement by going after individual health care executives in addition to the corporations they work for.

Should the executive be convicted, they can also be banned from doing business with government health programs.

In the past corporations have just paid the fines, and in some cases, simply passed on these costs to their client base.

“When you look at the history of health care enforcement, we’ve seen a number of Fortune 500 companies that have been caught not once, not twice, but sometimes three times violating the trust of the American people, submitting false claims, paying kickbacks to doctors, marketing drugs which have not been tested for safety and efficacy,” Lewis Morris, chief counsel for the inspector general of the Department of Health and Human Services told Associated Press.

With growing privatization in the delivery of public health care in Canada, there is some question as to the size of Medicare fraud here. The Canadian Health Care Anti-Fraud Association estimates health care fraud in Canada represents anywhere from two to 10 per cent of health care costs. The question is, where are the prosecutions, especially at a time when health care spending is so tight?

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