Buffalo Overbills: Medicaid Recipient Calls Ambulance 600 Times at Federal Expense

July 30th, 2009 8:47 PM

Here's an interesting example of government-run health care losing a sense of fiscal common sense. From Channel 2 in Buffalo comes the story of Scott Graham, a man with sickle-cell anemia that causes him stabbing pain.

Graham doesn't have a job, insurance or car. So, when he feels bad, he doesn't call a cab. He calls 911 to have an ambulance drive him to the hospital.

A 2 On Your Side investigation found that from January 2006 to May of this year, Rural Metro Ambulance picked him up 603 times.

Medicaid picked up the tab for each ride, costing taxpayers at least $118,158.

How does the federal government explain this kind of waste in the federal health system? Apparently, the bureaucrats were more interested in finding out who blew the whistle:

2 On Your Side contacted Medicaid to have them look into the number of times Graham used an ambulance. Medicaid appeared more interested in how we got the information, rather than how much it cost taxpayers to pick him up.

Medicaid fraud and abuse costs $60 billion each year nationwide.

2 On Your Side contacted our lawmakers to discuss how to lower that number.

"As we look at health care reform," Senator Kirsten Gillibrand (D-NY) said, "we should also look at oversight and accountability for those programs to make sure that people aren't abusing the system."

Gillibrand says cracking down on abuse should be part of the major health care reform going through Congress to force more oversight.

Take Mr. Graham's case. His trips cost Medicaid $118,000, but the government reimbursements are low. In fact, most ambulance companies lose money, up to 30% or more, when they transport Medicaid patients, because the government simply does not pay the full cost. Therefore, Mr. Graham's actual cost to the ambulance company and to the health care system in general, is much more, as high as $360,000.