U.S. Politics: L-Code Fraud & Abuse

U.S. Politics: L-Code Fraud & Abuse

First of all I am assuming California Medicare is called MediCal. I hope
this is correct.
Viewed a 60 Minutes television segment this past weekend regarding MediCal
fraud and abuse, focusing on DME providers. Millions of taxpayer dollars
supposedly being paid for items never sold. So bad the FBI had to get
involved. Among other things, back supports, shoes and custom inserts
were quoted. They briefly showed an L-code list. Provider numbers are given
to anyone with a Calif. drivers license and a street address with no
background checks. Out of 178 reported fraud and abuse cases last year, I
believe 8 were actually prosecuted.
There was no mention as to how this onslaught of fraud and abuse even started
some 3-4 years ago, and is now out of control. My guess is because HCFA,
back in 1994 (?), allowed other health care providers that were not ABC
certified, use of the L-codes. Perhaps this isn't the only reason. Is
MediCal getting all this attention because California is the most populous
state, and therefore, has increased liklihood of fraud and abuse? Is there
something unique about California's billing system that makes it more
suseptible to fraud and abuse? How bad is fraud and abuse in other states
proportionally I wonder?
Comments?

Paul Rieth, CPO