More than 80% of the money that Medicare paid to chiropractors in 2013 went for medically unnecessary procedures, a new federal audit found. The federal insurance program for senior citizens spent roughly $359 million on unnecessary chiropractic care that year for treatment of strains, sprains or joint conditions, a review by the Department of Health and Human Services’ Office of Inspector General found.
The OIG called on the Centers for Medicare and Medicaid Services to tighten oversight of the payments, noting its analysis was one of several in recent years to find questionable Medicare spending on chiropractic care. “Unless CMS implements strong controls, it is likely to continue to make improper payments to chiropractors,” the OIG said.
If you are surprised by the above, you shouldn’t be. This is just one of many similar reports on Medicare’s administration going back decades. Many of the audits also uncovered massive fraud gone undetected for years.
Medicare follows a pay and pursue (occasionally) policy processing claims and operates under strict bureaucratic guidelines. Try calling about a claim and discuss you concerns with the contractor processing claims; you aren’t allowed to speak with them.
Medicare should be doing what politicians criticize private insurers for doing; managing claims, questioning medical necessity, pre-approving certain services. Medicare attempts to control its costs (unsuccessfully) by controlling fees which is only half the equation.
Medicare is a political animal fearing the wrath of older voters. Every government-run system faces the same shortcomings. However, the more experienced systems have become comfortable with various forms of service control and rationing.