Thread: Medicare Fraud

Originally Posted by CowboyTed

Give us a link to support your claim and by the way you are pushing towards a solution of a more public system. NHS(British system) has very little fraud in comparision.

NHS has a monopoly and all the doctors are answerable directly to the government that employs them.

The advantage to that is low fraud, the disadvantage is that hospitals are like the DMV. And that's no exaggeration in the case of Britain. Britain has unusually bad health care, almost as bad as the US's.

BTW, fraud is an administrative cost, or at least it's the same thing in substance, if not in official stats.

Here's another link:

Medical Fraud a Growing Problem

Health-care experts say the simplicity of Campos Ramirez's scheme underscores the scope of the growing fraud problem and the need to devote more resources to theft prevention. Law enforcement authorities estimate that health-care fraud costs taxpayers more than $60 billion each year.

A critical aspect of the problem is that Medicare, the health program for the elderly and the disabled, automatically pays the vast majority of the bills it receives from companies that possess federally issued supplier numbers.

Originally Posted by adaher

NHS has a monopoly and all the doctors are answerable directly to the government that employs them.

The advantage to that is low fraud, the disadvantage is that hospitals are like the DMV. And that's no exaggeration in the case of Britain. Britain has unusually bad health care, almost as bad as the US's.

BTW, fraud is an administrative cost, or at least it's the same thing in substance, if not in official stats.

Here's another link:

Medical Fraud a Growing Problem

Health-care experts say the simplicity of Campos Ramirez's scheme underscores the scope of the growing fraud problem and the need to devote more resources to theft prevention. Law enforcement authorities estimate that health-care fraud costs taxpayers more than $60 billion each year.

A critical aspect of the problem is that Medicare, the health program for the elderly and the disabled, automatically pays the vast majority of the bills it receives from companies that possess federally issued supplier numbers.

Used the British system a number of times.. Didn't find too much wrong.

Again you just bang out the UK system is crap but with no proof.

Life expectancy, infant mortality, cancer survival rates... Easy enough to look up. Only the US does worse on life expectancy, but we are better at life expectancy past 65, which if nothing else shows that the US's Medicare system is superior to the NHS.

WEll, not superior. Medicare pays for everything, seniors in Britain have to use the same health care system everyone else uses.

CARPE DIEM: Life Expectancy Higher in US than UK at Age 65+

Britain is now going to ration cancer screening, which will further worsen the already worst cancer survival rates in the Western world:

GPs told to ration cancer scans in bureaucratic directive | Mail Online

Originally Posted by hairballxavier

Feds make more arrests in major Medicare fraud case

Hooray!!! they arrested some more of the bastards that are ripping off the taxpayers!

The big problem is that of course this is just the tip of the iceberg. I'd bet that about half the money spent on Medicaid/Medicare is lost to fraud. And that's a huge chunk of the federal budget.


EDIT: Here's more from the FBI website...

Health Care Fraud Takedown
111 Charged Nationwide



111 people in 9 cities.

This story just infuriates me, not because of the Medicare fraud, which is bad enough, but because of what was done to the patients. The bitches need to be hung for this!

3 charged in alleged chemotherapy fraud in Miss.
HOLBROOK MOHR, Associated Press
Updated 05:45 p.m., Friday, September 9, 2011


JACKSON, Miss. (AP) — A clinic in south Mississippi gave cancer patients less chemotherapy or cheaper drugs than they were told and reused the same needles on multiple people as part of a multimillion-dollar Medicare and Medicaid fraud, a 15-count indictment alleges.

Three women, including Dr. Meera Sachdeva, the 50-year-old founder of Rose Cancer Center in Summit, were charged in the indictment Thursday. The clinic had already been shut down by the state Health Department for "unsafe infection control practices."

Sachdeva has been ordered held without bond.

The others charged in the case are employees, 24-year-old Brittany McCoskey of Monticello and 43-year-old Monica Weeks of Madison.

The defendants "knew that the liquid solutions that were infused into the patients treated at Rose Cancer Center contained a smaller amount of the chemotherapy drugs than the defendants had billed to various health care benefit programs, or contained different, less expensive drugs," the indictment says.

The clinic also allegedly billed the agencies for new syringes for each patient, even though it reused some syringes on multiple people.

Prosecutors say Medicaid and Medicare paid the clinic $15.1 million during the alleged scheme. Authorities have seized $6 million.

Sachdeva's attorney, Rob McDuff, said "she'll enter a plea of not guilty and we'll go from there."

When contacted Friday, McCoskey said she did not know she was indicted and wanted to read the indictment before commenting.

It wasn't clear if Weeks had an attorney. A phone call to a listing for Weeks was not immediately returned.

Prosecutor Scott Gilbert said Sachdeva was arrested in August and ordered held without bond. She appealed that ruling, but it was upheld Friday by a different judge.

Prosecutors argued that Sachdeva should remain in jail until trial because she's a naturalized U.S. citizen from India, routinely travels to her native country and is a flight risk.

"Moreover, the defendant has substantial financial resources available to her, in spite of the seizure of almost $6,000,000 by the government," court records said.

Rose Cancer Center came under scrutiny earlier this year when 11 patients went to hospitals with bacterial infections, according to the Mississippi Department of Health.

Liz Sharlot, a Health Department spokeswoman, said Friday that the clinic was closed July 20. The Health Department advised patients to get screened for Hepatitis B and C and HIV, though officials have not found anyone who got a viral infection as a direct result of treatment at the cancer center.

Sharlot said 150 to 200 patients have been screened and the department will conduct additional testing.

Federal authorities began investigating the clinic after a confidential informant told them the suspects were "altering, forging and destroying patient records in anticipation of a Medicare audit," court records said. Authorities said they found shredded documents when the clinic was raided the next day.

Sachdeva faces up to 165 years in prison and more than $3.2 million in fines if convicted.

McCoskey was a receptionist and later the office manager at Rose Cancer Center. Weeks submitted the claims for Rose Cancer Center to Medicare, Medicaid and private insurance companies.

McCoskey and Weeks are both charged with 11 counts and, if convicted, face 125 years in prison and $2.25 million in fines.

"My office will remain vigilant as health care fraud investigations continue to ensure that patients receiving treatment are being provided the appropriate and adequate treatment," U.S. Attorney John Dowdy told The Associated Press on Friday.

"The patients in the case are truly as much as victims as the government," he said. "There was over $15 million in claims that she made through Medicaid and Medicare. It's disturbing to see this kind of fraud continuing when the federal government is looking for ways to cut costs."

3 charged in alleged chemotherapy fraud in Miss. - Houston Chronicle

Originally Posted by Mrs. M

This story just infuriates me, not because of the Medicare fraud, which is bad enough, but because of what was done to the patients. The bitches need to be hung for this!


3 charged in alleged chemotherapy fraud in Miss. - Houston Chronicle

That looks like a particularly deplorable case of fraud because the patients actually thought they were being treated.

In many cases of fraud the "patients" are active participants in the scam or simply unknowing victims of identity theft. In that case the patients were put in danger.

-----------------

Here's some more on this issue.

Los Angeles: Medicare Fraud Summit Law Enforcement Panel - YouTube

And people who don't think this health care fraud is a big issue should look at the federal budget see how big of a slice of it is Medicare/Medicaid/CHIP.

Originally Posted by adaher

Life expectancy, infant mortality, cancer survival rates... Easy enough to look up. Only the US does worse on life expectancy, but we are better at life expectancy past 65, which if nothing else shows that the US's Medicare system is superior to the NHS.

WEll, not superior. Medicare pays for everything, seniors in Britain have to use the same health care system everyone else uses.

CARPE DIEM: Life Expectancy Higher in US than UK at Age 65+
h
Britain is now going to ration cancer screening, which will further worsen the already worst cancer survival rates in the Western world:

GPs told to ration cancer scans in bureaucratic directive | Mail Online

So US have lower life expectancy and infant mortality...
Cancer Survival does not stipulate a better or worse healthcare system
Cancer Rates and Unjustified Conclusions | FactCheck.org

I am sorry but I take anything serious out of the Daily Mail... I wouldn't believe the tv listing from them...

Originally Posted by hairballxavier

Feds make more arrests in major Medicare fraud case

Hooray!!! they arrested some more of the bastards that are ripping off the taxpayers!

The big problem is that of course this is just the tip of the iceberg. I'd bet that about half the money spent on Medicaid/Medicare is lost to fraud. And that's a huge chunk of the federal budget.


EDIT: Here's more from the FBI website...

Health Care Fraud Takedown
111 Charged Nationwide



111 people in 9 cities.

When a government program fails, and most will, the government just starts a new program which does the same thing as the old one, gives it a new name but then keeps the old program which failed to start with. This is the way government operates and the reason we have such a huge deficit.