It may take a bit of effort, but a huge part of Medicare abuse is that HHS can't know all the details of all procedures.
But if they're alerted to "you may want to look at shoulder replacements by this provider" then they can definitely put it under more scrutiny.
It'd be great if they had proactive systems to alert... but my guess is the size of the healthcare market at Medicare scale somewhat preclude open-ended, continuous queries.
I'd encourage her to try to reach out to HHS. https://www.medicare.gov/basics/reporting-medicare-fraud-and...
It may take a bit of effort, but a huge part of Medicare abuse is that HHS can't know all the details of all procedures.
But if they're alerted to "you may want to look at shoulder replacements by this provider" then they can definitely put it under more scrutiny.
It'd be great if they had proactive systems to alert... but my guess is the size of the healthcare market at Medicare scale somewhat preclude open-ended, continuous queries.