The billion-dollar health scam the federal government won’t stop

By Kelly Hooper. Excerpts:

"For 12 years, a Department of Transportation employee fraudulently enrolled his sister and niece on his federal health benefits plan. He claimed the two were his wife and stepchild.

An equipment repair worker at an Army facility in Alabama kept an ex-wife covered for 14 years, and was caught only when he tried to add his new wife. And at the Department of Justice, an employee added a friend and her friend’s four children, asserting they were her family members.

These are a few of what federal officials believe to be thousands of health insurance enrollment scams that cost the federal government as much as $3 billion every year.

And it’s surprisingly easy to do.

The Office of Personnel Management, which oversees health insurance for 8 million federal workers and their families at a cost of more than $60 billion a year, has never checked the eligibility of those on its rolls, according to a report from the Government Accountability Office, which has been pushing OPM for years to improve its oversight. And that failure is costing taxpayers billions and raising premiums for millions of civil servants.

“OPM does not care about fraud, or they would do it. It's not that hard,” said Scott, who requested the GAO report. “Companies do it all the time, and states do it all the time. It's real simple to put a program in place to do it, so if you don't do it, that means you support fraud.”"

"Despite prodding from the GAO, the agency has no plans to conduct an audit because it said it would be too expensive."