There is an old story about Harry Truman making a campaign speech at a Native-American reservation out West. As he began his speech, he heard a few murmurs from the crowd, punctuating the key points of his stem-winder. As he continued his speech, he could make out the word they were using - goomata. He had no idea what the word meant, but figured it was something good, because whenever he hit a major point of his speech, the crowd was in a frenzy, shouting "goomata, goomata!" pumping their fists in the air. Truman thought, "wow, this speech is golden - they love me!"

As Truman was leaving the podium and walking across the field, he had the misfortune of stepping into a rather large, fresh pile of cow dung. One of the Tribal leaders escorting Truman looked down and said, "Oh, Mr. Truman, you just stepped in a pile of goomata."
Fast forward sixty-odd years.

Check out a wonderful piece of news reported by Charles Duhigg at the venerable New York Times. Charles Duhigg reports that senior Medicare officials issued a self-laudatory report in 2006 heralding the agency's success in stemming fraud, touting the fact they drove down improper payments by an estimated $700 million.

What Duhigg's story points out, though, is that the folks at Medicare gamed the study - they told the inspectors where to look, and where not to look.

A report recently issued by the Office of the Inspector General is very critical of the Medicare study, and paints a dramatically different picture. In one instance, they note that Medicare did not take a step required by law: comparing invoices for wheelchairs with the medical records from physicians, ensuring that a doctor actually requested the equipment. In some cases, the Inspector General had trouble locating records of the equipment order from the physician, as well as finding evidence that the equipment was actually supplied to the patient.

The Inspector General estimates that the amount of fraud around wheelchairs and other medical equipment totals $2.8 billion. That is just for medical equipment.

I know that both the Inspector General and New York Times reporter Duhigg are bound by rules of propriety, but I wonder if they read Medicare's claims of success around fraud prevention and shout "goomata!"

Our firm has a great deal of interest in this issue. We are working with a number of people who have first-hand knowledge of these issues, and are preparing to move forward with action. If you - or someone you know - know of examples of Medicare fraud, we would love to hear from you.