Estimate of FRAUD in U.S. National Health Care System 1990 to 1998

Year

1998

1997

1996

1995

1994

1993

1992

1991

1990

National Health Expenditures (in $ millions)

$1,149,066

$1,088,230

$1,039,428

$993,275

$947,745

$898,496

$836,537

$766,783

$699,361

Population (in millions of people)

281

278

276

273

271

268

266

263

260

Per Capita, National Health (amount in $)

$4,094

$3,912

$3,772

$3,637

$3,501

$3,351

$3,151

$2,918

$2,689

Medicaid (in $ millions)

$170,607

$159,988

$154,059

$146,115

$134,601

$121,748

$106,370

$93,942

$75,373

Medicare (in $millions)

$216,588

$211,256

$199,370

$185,323

$166,914

$148,702

$136,164

$121,138

$111,496

Medicare (in $millions)

$387,195

$371,244

$353,429

$331,438

$301,515

$270,450

$242,534

$215,080

$186,869

Size of Insured/Taxpayer Market= about 69.5 % of U.S. population (in millions of people)

195

193

192

190

188

186

185

183

181

Size of Insured/Taxpayer Market= total National Health Expenditures minus Medicare and Mediaid costs (in $millions)

$761,871

$716,986

$685,999

$661,837

$646,230

$628,046

$594,003

$551,703

$512,492

Estimate of fraud in Medicare @ 9.713 percent/year(in $millions)

21,037

20,519

19,365

18,000

16,212

14,443

13,226

11,766

10,830

Estimate of fraud in Medicaid @ 10.96 percent/year (in $millions)

18,699

17,535

16,885

16,014

14,752

13,344

11,658

10,296

8,261

Estimate of fraud in the insured/taxpayer market @ 9.97 percent/year (in $millions)

75,959

71,484

68,394

65,985

64,429

62,616

59,222

55,005

51,095

Estimate of TOTAL Fraud (in $millions)

$115,694

$109,537

$104,644

100,000

$95,394

$90,403

$84,106

$77,067

$70,186

Estimate of TOTAL Fraud (in $billions)

$115.7

$109.5

$104.6

$100.0

$95.4

$90.4

$84.1

$77.1

$70.2

Data from 1999 Report of the Health Care Financing Administration, HHS