Posts Tagged ‘Medicaid Fraud’

Poll: Cut waste, fraud and abuse, but not Medicare benefits, say Americans

by Jim Kouri on Sunday, October 30th, 2011

“Eight out of 10 American voters oppose across-the-board cuts to Medicare or higher fees for beneficiaries; Strong majority don’t think government is doing enough to address wasteful and fraudulent spending.”

Obama promised hope and change in health care. Instead, voters got the short end of the stick and the promise of less health care. Credit: NewswithViews

A national survey of registered voters released Friday reveals a large majority of Americans think the Obama Administration and U.S. Congress are capable of preventing the loss of taxpayer dollars to waste, fraud and abuse within Medicare, and they strongly favor real efforts — not campaign promises — to reduce costs through program integrity efforts and tougher enforcement.

According to Steven Malanga of the Manhattan Institute, experts estimate that “abuses of Medicaid alone eat up at least 10 percent of the program’s total cost nationwide — a waste of $30 billion a year. Unscrupulous doctors billing for over 24 hours per day of procedures, phony companies invoicing for phantom services, pharmacists filling prescriptions for dead patients, home health-care companies demanding payment for treating clients actually in the hospital — on and on the rip-offs go.”

The cheating is brazen because scam artists have figured out that years of lax oversight have made Medicaid easy plunder, according to Malanga.

The General Accountability Office recently reported that Medicare/Medicaid fraud and abuse are responsible for losses totaling upwards of $60 billion per year.

The telephone poll, conducted October 19 and October 20 by Fabrizio, Ward & Associates and Greenburg Quinlan Rosner Research among 1,000 voters nation-wide, shows approximately 70 percent of respondents feel the federal government is not doing enough to properly address fraud and favor serious efforts to stop the tens of billions of taxpayer dollars being lost each year to fraud, abuse and waste in Medicare and Medicaid.

“The sentiment of U.S. voters expressed in this recent poll should be no surprise to policymakers,” said Suzanne Mintz, President and CEO of the National Family Caregivers Association.

“No one wants to see dollars line the pockets of criminals. Our lawmakers — particularly members of the Joint Select Committee on Deficit Reduction –- have an opportunity to effect positive change, without negatively impacting the health and well-being of America’s eldest and most vulnerable citizens,” she said.

According to political strategist Mike Baker, the Democrats routinely accuse of the Republicans of wishing to tinker with Medicare and Medicaid, but they will turn around and reduce Medicare or Medicaid benefits and increase the elderly’s out-of-pocket costs.

“If you want to know what Democrats are planning to do with Medicare, just listen to what they accuse Republicans of doing. It’s the old ‘accuse others of what you do’ strategy,” Baker said.

The poll findings revealed 83 percent of respondents oppose cuts to Medicare and higher fees on beneficiaries -– two key issues under consideration this month by the Joint Select Committee on Deficit Reduction, which is attempting to find at least $1.2 trillion in savings from federal programs by the end of the year.

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A healthcare conspiracy theory that bears investigation …

by Stephen Levine on Friday, May 27th, 2011

This is article 183 of 687 in the topic Healthcare

Here is a story about waste, fraud and corruption that bears repeating …

The Obama Administration rejected the offer of IBM to supply the Healthcare Administration with specialized software which would reduce Medicare and Medicaid fraud by approximately $900 BILLION … enough to pay for the preliminary portion of ObamaCare. Free of charge — to prove the systems capabilities. The Obama Administration not only rejected the offer once – but twice.

This was not a secret deal, it was widely reported …

So why did Obama turn down IBM’s offer which would have benefited all healthcare recipients?

One, reason, which is relatively understandable in the course of normal business relations, is related to the political lobbying of vendors who were opposed to giving IBM a major advantage in supplying a critical system to the government without a lengthy and costly competitive bidding procedure. Both profits and political jealousy seem to have been key motivations.

Two, the second reason involves a conspiracy theory that needs to be investigated. Basically, the insurance gatekeepers of the healthcare system profit mightily from the waste, fraud and abuse of the system because they are reimbursed for such fraudulent or wasteful activities by taxpayer dollars. Therefore, a reduction in waste, fraud and abuse would also result in a reduction in their profits – and cushy executive bonuses.

Holding Obama and the democrats accountable in 2012 …

There is little or no doubt in my mind that Obama and his fellow travelers are attempting to hijack the United States economy for the purposes of implementing their own progressive political ideology as well as perpetuate control over major government activities by installing a permanent progressive cadre of unelected officials with the power to extend the power of the progressive democrats long after Obama leaves office – no matter who inhabits the White House or controls the Administration in the coming years.

One only needs to see that Obama’s global warming and environmental initiatives would give politicians control over energy generation, transmission, usage and pricing – the guts which drive the economic engine of the United States.

Similarly, control over the administration of healthcare would grant the government similar control over individual citizens – literally giving the government the power to decide which people would live and which people would die. Especially dangerous since the progressive agenda is based on the power derived from managing scarce resources, be they energy- or heath-related. Not to mention their mantra of “population control” to preserve these resources for the “collective” future generation.

Bottom line …

As a data processor who is intimately familiar with computing, many anti-fraud checks and balances can be built into government systems at a relatively small cost as measured against the benefits they provide to the American people.

Whether we are speaking of a tightly-controlled identification card that uses the existing technology of the credit card issuers to check immigration status and eligibility for government programs or checking the validity of medical payments … it is all doable and doable NOW.

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10 percent of Medicare payments are fraudulent

by John Lott on Thursday, March 3rd, 2011

This is article 6 of 8 in the topic Entitlement Programs

The estimate of fraud leaves out certain obvious instances of fraud from the nearly 10 percent claim.

Nearly 10 percent of all Medicare payments are fraudulent or otherwise improper, and the government isn’t doing enough to stop them.

That’s the conclusion of a Government Accountability Office report released Wednesday. The report, issued at the request of a House subcommittee investigating Medicare and Medicaid fraud, estimates that the federal government is losing $48 billion on the improper payments – a significant amount for a program that “is fiscally unsustainable in the long term” unless action is taken.

The report, prepared for a House Energy and Commerce Oversight Subcommittee hearing, said “CMS needs a plan with clear measures and benchmarks for reducing Medicare’s risk for improper payments, inefficient payment methods and issues in program management and patient care and safety.”

CMS estimates that $48 billion of estimated Medicare outlays of $509 billion in fiscal 2010 went to improper payments, including fraudulent ones. “However, this improper payment estimate did not include all of the program’s risk since it did not include improper payments in its Part D prescription drug benefit, for which the agency has not yet estimated a total amount,” said Kathleen King, director of GAO’s health care team. . . .

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Physicians allegedly committing fraud to help Wisconsin protesters

by Jim Kouri on Friday, February 25th, 2011

This is article 61 of 338 in the topic Criminal Activity

Fraud: “An intentional perversion of the truth for the purpose of inducing another in reliance upon it to part with some valuable thing belonging to him or to surrender a legal right; a false representation of a matter of fact, whether by words or by conduct, by false or misleading allegations, or by concealment of that which should have been disclosed, which deceives and is intended to deceive another so that he shall act upon it to his legal injury.” – Black’s Law Dictionary

Many hope these protesters are not teachers but just supporters. Photo: NewswithViews

Some Wisconsin doctors have offered, at a public event, to write sickness excuses on request for protesting teachers, according to ABC and Fox News. A spokeswoman said that they knew they could “get in trouble,” but would take the risk because “teachers have no choice.”

The teachers’ choice is to go to work, or go without pay and risk being fired. “It’s the same choice faced by everyone in the world who can’t use someone else’s earnings to pay the bills,” said Jane Orient, M.D., executive director of the Association of American Physicians and Surgeons (AAPS).

“Writing a phony sickness excuse is fraud,” said the veteran medical profession.

Doctors are frequently under intense pressure to do this, or to misstate diagnoses, to ‘help’ patients who want to collect sick pay, insurance payments, disability, or other benefits to which they are not lawfully entitled. For doctors to advertise their willingness to do so is, however, distinctly unusual.

“Physicians who sign their name to a false statement are compromising their professional integrity,” said Orient, “although the Wisconsin union supporters seem to believe that the end justifies the means. The penalties can be very severe; for Medicare or Medicaid fraud, they include delicensure, draconian fines, and lengthy prison terms.”

Public employees are forbidden to strike. A sick-out is the functional equivalent of a strike. Teachers who ask for a false excuse, and physicians who knowingly provide one, are both subverting the law intended to protect the public against suspension of essential services.

Physicians, like other citizens, have the right to take a political stand. They may lawfully go to the protest, or contact their elected officials. Apparently, they are not contributing voluntarily to a fund to pay teachers who stay home, but want the taxpayers to do that, according to Dr. Orient.

Patients who respect their physician should not ask him or her to lie. And everyone should be questioning the wisdom of caving in to a pressure group that is willing to use professional lies as a tool to overturn the voice of the electorate, states Orient.

AAPS officials state that they represent physicians in all specialties nationwide, believe in the sanctity of the patient-physician relationship and in the rule of law under the U.S. Constitution.

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