A Lewiston couple sat shame-faced in an Androscoggin County courtroom last week as a judge pronounced them guilty of stealing about $20,000 in housing benefits intended for the poor.

The husband and wife obtained the money by claiming to have little or no income, even as they bought two apartment buildings with cash.

The trial accomplished several worthy purposes, the most important of which was symbolic.

The conviction sent a message to people who steal from taxpayers: If you cheat, you may be caught. When you are caught, you will be severely punished and humiliated.

Message sent and, we hope, received.

Individual welfare fraud has become a growing political obsession in Maine.

Taxes are high, our incomes have likely dropped, many of us are angry and worried.

Just the thought of supporting undeserving people is infuriating.

And it is natural to be the most suspicious of what we see with our own eyes, the people we happen to observe on the street and in the checkout lines at retail stores.

So it’s easy to miss the fraud we cannot see, the fraud committed by lawbreakers wearing suits and ties, and there’s plenty of that.

Which is why we tried to bring some perspective to the welfare fraud problem in a front-page story Sunday.

Over the past three years, Maine judges have ordered individuals who have defrauded benefit programs to repay $488,303, or an average of $162,767 per year.

That’s a big number, but look at this:

Over the past four years, Maine has received $18.7 million from Medicaid and Medicare providers who have cheated the system, for an average of $4.6 million per year.

That’s about $28 dollars in provider fraud recovered for every $1 of individual restitution ordered.

And there is no telling how much of the restitution ordered by judges is actually received by the state of Maine.

The most maddening thing about fraud is that nobody can really put a finger on its frequency or cost. 

Estimates of Medicaid and Medicare fraud range from 2 percent to 20 percent, but nobody knows for sure.

That’s because the people committing fraud, both corporate and individual, do everything in their power to cover their tracks.

Gov. Paul LePage and many legislators are convinced that individual welfare fraud is rampant in Maine.

Attorney General Janet Mills, meanwhile, says what Maine has already collected from fraudulent providers is only the tip of the iceberg.

The difference here is scale: Should we assign more highly paid state employees, like investigators, lawyers and judges, to ferreting out the small fry?

Or should we focus equal or greater attention on the big fish, the providers who may be stealing money hand over fist.

In 2012, Maine received four settlements of more than $1 million from providers, the largest of which was $4,402,994 from the drug company Glaxo Smith Kline.

Now that’s a good payday.

Glaxo Smith Kline was accused of promoting drugs for unapproved uses, failing to report safety data and false pricing practices.

Abbott Laboratories, meanwhile, paid Maine $1,607,808 in another settlement the same year.

In fact, Medicaid, Medicare and even private insurance companies lose billions a year on fraudulent provider claims.

This includes phantom billing for services not delivered, up-coding of services to obtain more reimbursement, double billing for the same services or dispensing generic drugs while billing brand-name drugs.

Just as we know there is welfare fraud in Maine, we know there is provider fraud as well.

The banking crisis of 2008 clearly showed crime is about as common on Main Street as it is on Wall Street.

Yet, Gov. LePage and Republicans in the Legislature have only launched a campaign to fix the leaky cracks in the boat rather than first plugging the holes in the hull.

As we said, it is important to pursue fraud at all levels. But let’s also insist the state put as much more energy into going after the big crooks. That’s where the money is.

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The opinions expressed in this column reflect the views of the ownership and the editorial board.


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