Credit card companies have sophisticated software that can identify a suspicious transaction anywhere in the world and automatically report it to the cardholder. Medicare has only recently, through the new Affordable Care Act, received funding to develop similar software to flag billings on behalf of dead people and charges from providers for more than 24 hours of service a day.

Health care financing involves a lot of tough choices. Which treatments should be covered, and which are too unproven or unaffordable for insurers? How high can co-pays go before they discourage people from getting the care they need to prevent more expensive problems later?


But there's one category of health care spending we can all agree we can’t afford: fraud.


Last week, the Massachusetts attorney general's office charged a company, its owner and two employees in Framingham, Mass., with bilking the state Medicaid program of $5.5 million by charging for services they did not provide, including bills submitted for work on patients who had already died.


"We believe this scheme was systematic," Attorney General Martha Coakley said during a Boston press conference, discussing the charges against Adlife Healthcare and three other Massachusetts companies accused of Medicaid fraud.


That's small change compared with the fraud of a Florida health care company recently convicted of charging Medicare for more than $200 million for services never provided. One executive of that firm, American Therapeutic Corp., was sentenced to 50 years in prison.


There's more: An Indiana medical equipment business just agreed to pay $42 million to settle a federal civil suit charging Medicare fraud. And last month, the Justice Department charged 91 people in eight cities with bilking Medicare to the tune of $300 million. One of those charged was a Detroit psychotherapist caught billing for treatments that added up to more than 24 hours a day.


As with any case, it's hard to know whether these prosecutions are making a real dent in the problem or just exposing the tip of the iceberg. But we can assume there's more fraud where that came from. Health care is a huge, sprawling, lucrative target, and law enforcement has traditionally lacked the tools to police it effectively.


For example, credit card companies have sophisticated software that can identify a suspicious transaction anywhere in the world and automatically report it to the cardholder. Medicare has only recently, through the new Affordable Care Act, received funding to develop similar software to flag billings on behalf of dead people and charges from providers for more than 24 hours of service a day.


With ever-rising health costs and ever-growing budget woes, there is always pressure to cut funding for functions deemed not essential to core services. But when every dollar counts, anti-fraud enforcement is essential.


We cannot afford to let scarce health care dollars be paid to individuals and companies that did not earn them.


-- The MetroWest Daily News (Mass.)