Comments on: Audits For Medicare Providers http://www.healthinsurancecolorado.net/blog1/2009/02/19/audits-for-medicare-providers/ Research and discussion of the Colorado health insurance industry and the healthcare crisis in America. Wed, 17 Mar 2010 21:46:03 +0000 http://wordpress.org/?v=abc hourly 1 By: Don Levit http://www.healthinsurancecolorado.net/blog1/2009/02/19/audits-for-medicare-providers/comment-page-1/#comment-13025 Don Levit Fri, 20 Feb 2009 17:36:25 +0000 http://www.healthinsurancecolorado.net/blog1/?p=1010#comment-13025 Louise: Fraud is an area that needs to be assessed, in order to keep as many people as honest as possible. Fraud goes both ways, both to Medicare and from Medicare. As you probably know, the trust funds for Medicare and Social Security are filled with loans, rather than cash (or assets which can be liquidated into cash). The payroll tax dollars are spent on other governmental expenses. As an "insurer," it would be foolish to conceive of a private sector entity leveraging its premiums and interest to pay for non insurance expenses. Probably most people are aware these trust funds are filled with IOUs, so this behavior is not fraudulent. What many people may not realize is that this "raiding" of the trust funds to pay for other expenses is legal. The U.S. Supreme Court in Helvering v. Davis, 301 U.S. 619 (1937) states "The proceeds of both taxes are to be paid into the Treasury like internal revenue taxes generally, and are not ear marked in any way. Section 807(a), 42 U.S.C.A. 1007(a)." "The first section of this title creates an account in the U.S. Treasury to be known as the Old-Age Reserve Account. No present appropriation, however, is made to that account. All that the statute does is to authorize appropriations annually. Not a dollar goes into the account by force of the challenged act alone." "Whether wisdom or unwisdom resides in the scheme of benefits set forth in Title 2, it is not for us to say. The answer to such inquiries must come from Congress, not the courts. Our concern here is with power, not with wisdom." Don Levit Louise:
Fraud is an area that needs to be assessed, in order to keep as many people as honest as possible.
Fraud goes both ways, both to Medicare and from Medicare.
As you probably know, the trust funds for Medicare and Social Security are filled with loans, rather than cash (or assets which can be liquidated into cash).
The payroll tax dollars are spent on other governmental expenses.
As an “insurer,” it would be foolish to conceive of a private sector entity leveraging its premiums and interest to pay for non insurance expenses.

Probably most people are aware these trust funds are filled with IOUs, so this behavior is not fraudulent.
What many people may not realize is that this “raiding” of the trust funds to pay for other expenses is legal.

The U.S. Supreme Court in Helvering v. Davis, 301 U.S. 619 (1937) states “The proceeds of both taxes are to be paid into the Treasury like internal revenue taxes generally, and are not ear marked in any way. Section 807(a), 42 U.S.C.A. 1007(a).”
“The first section of this title creates an account in the U.S. Treasury to be known as the Old-Age Reserve Account. No present appropriation, however, is made to that account. All that the statute does is to authorize appropriations annually. Not a dollar goes into the account by force of the challenged act alone.”
“Whether wisdom or unwisdom resides in the scheme of benefits set forth in Title 2, it is not for us to say. The answer to such inquiries must come from Congress, not the courts. Our concern here is with power, not with wisdom.”
Don Levit

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