Audit: More Than 23K Potentially Fake Addresses Of Health Care Providers In Medicare Program

A recent audit from the Government Accountability Office (GAO) discovered more than 23,000 potentially fake or bad addresses of health care providers in the Medicare program.

The report sheds light on instances of Medicare providers registering addresses as vacant lots, mailboxes, and, in one case, a fast-food chain that has been located at the listed practice address for years–problems that make the program susceptible to greater fraud and abuse.

The report said that in 2014, more than $60 billion in taxpayer dollars was spent on improper Medicare payments. The figure accounts for more than 10 percent of the entire Medicare budget.

The audit, conducted from January 2014 to June 2015, used a USPS management tool to verify locations of people and practices enrolled in a centralized database of Medicare providers. Prospective Medicare providers must be listed in the database, known as the Provider Enrollment, Chain and Ownership System (PECOS), before they can provide services to Medicare beneficiaries.

The GAO investigation found that many of the addresses that set off red flags. Of the 105,234 addresses initially appearing as either a Commercial Mail-Receiving Agency, vacant, or an invalid, an estimated 23,400–22 percent–were deemed ineligible addresses. Of these addresses, 19,900 were found to be invalid, 3,200 vacant, and 300 registered as commercial mail receiving agencies.