OK Dueling Docs react to HHS Report’s identification of Medicare discrepancies

OKLAHOMA CITY – A report from the Inspector General (IG) at the U.S. Department of Human Services drew sharply conflicting reactions from two Oklahoma physicians. One is a well-known advocate of the Affordable Care Act (ACA) and Medicaid expansion, while the other is one of the most passionate state critics of the system many call “ObamaCare.” 

The IG’s report, issued a month ago, found Medicare databases were riddled with errors, leaving the system open to fraud. 

However, Dr. Katherine Scheirman, a retired U.S. Air Force veteran and member of Doctors for America, said there is less than meets they eye in the inspector general’s report.

In an interview with CapitolBeatOK, Scheirman insisted, “Per the IG report, the discrepancies between the two databases were primarily office locations and contact information (phone numbers). The fixes recommended by the IG, and agreed to by CMS, appear reasonable and designed to improve the processes of updating this type of information.”

Dr. Scheirman, who served as one of the military’s highest ranking physicians before her retirement, also pointed to a recent news report in USA Today finding that the U.S. government has recovered some $14.9 billion in “Medicare fraud money.” 

Dr. Mike Ritze – a Republican who serves in the state House of Representatives – said, “the Obama administration and its backers still paint rosy pictures of what the massive takeover of the industry will bring. … Apologists, such as The Washington Post’s Ezra Klein, are resorting to feeble, misdirected contentions — not that the measure itself is outstanding, but rather that we are stuck with it. Once millions are hooked, advocates expect, those who have become dependent won’t want to give up their federal crutches.”

Ritze told CapitolBeatOK Obama administration’s cost projects are riddled with errors:  

“A report by the Society of Actuaries released in March concluded that insurance companies will have to pay an average of 32 percent more for claims on individual health policies under ObamaCare. If you want to see who will really bear the additional cost when it is passed along, take a look in the nearest mirror. The estimated boost in California is about 62 percent; for Wisconsin and Ohio, around 80 percent; and, in Maryland, around 67 percent.” 

Rep. Ritze continued, “The administration tried to muddy the waters in its responses to the study. Health and Human Services Secretary Kathleen Sebelius, in essence, called the results the fault of young and healthy people who have chosen less expensive, catastrophic coverage.  Personal choice is so old-fashioned, one gathers.”

The more recent national report from the HHS IG found the Centers for Medicare and Medicaid Services did not verify information provided to the databases called the National Plan and Provider Enumeration System and the Provider Enrollment, Chain and Ownership System (more popular known as PECOS). 

The IG’s critical analysis concluded, “The suspension of provider enrollment verification activities at a time of increased application volume could have compromised the accuracy and completeness of PECOS data, increasing the vulnerability of the Medicare program to fraud and abuse.” 

You may contact Patrick B. McGuigan at Patrick@capitolbeatok.com and follow us on Twitter: @capitolbeatok.