Mailboxes blown up on West Side Road in Weld

That is the size of the problem. $60 billion out of about $551 billion in expenditures about 11%.
Let's understand what Medicare Fraud and Asbuse is. Medicare Fraud and Abuse is any billinging to Medicare that covers services not delivered or a service that was delivered but was unnecessary or inappropriate (given to someone not qualified for the service.
The mismatch of qualified people to services is low, technical, and almost always caught after the fact by computers. Its the error rate of medicare and will never be zero but also may reach the point where its not worth pursuing if the costs to pursue are high.
The major medicare fraud is provider mis-billing that is separated between deliberate fraud and provider billing errors. Our Speaker of the House can speak to this since he misbilled Medicare by $1.6 million. He claims it was an error (billing for one class of product when really a different class was provided). Most of the provider errors are caught in the billing process. What remains is deliberate fraud.
For the first time and about time, the Obama administration has elevated Medicare Fraud and Abuse to a cabinet position. The HEAT team of cabinet officers was established in 2009 to specifically address and presecute deliberate fraud. Its done some good but not enough.
But Medicare Fraud and Abuse is about errors in the billing process. The $60 billion does not refer to expenditures. It refers to billing errors. In 2010 "improper payments" were about $48 billion of which an unknown amount were later found to be correct and proper.
Columbia Healthcare paid about a billion dollars in fines and penalties a few years back for deliberate fraud.
ut medicare was set up for fast and easy payments to providers not for verification. As time has gone on the system is being changed to put more and more emphasis on proper payments. So its not like little is being done. Just that much more needs to be done.
The fundamental point tho' is that patients are almost never involved in fraud.