Posted on 08/03/2008 7:59:45 AM PDT by devane617
This is an incredible read. Please go to link to see the massive fraud going on in South Florida.
They will all get a blank check under an Obama administration.
Oh, goodie. Let’s turn the whole health care system over to the federal government.
My first reaction also. Imagine what it will be like when the feds take of all medical programs.
Do you suppose we should alert SIXTY MINUTES?
Think they might do a story on how a big Democrat inspired program is nothing but a home to fraud?
Or is CBS still too busy ginning up fradulent documents about Republicans?
I checked the first 30 perps. All hispanic except for one French-Canadian.
This is old news. Been going on down there for at least the last 20 years.
...old news is exactly correct. so, my surprise is because the MH wrote a story about it...Last stat i heard had 10% of medicare payments, for the entire nation, going to dade/broward counties.
That's not really surprising since Dade County (Miami) is about 80% Hispanic. Most are citizens, probably Cuban descent
Sort of like comparing the top thirty criminals in Japan as Asian
Seriously, give away money, and what does one expect?
According to the census bureau it is 60%. Also, I forgot to mention that most of the 30 had fled the jurisdiction. So, there were not that many native born hispanics involved.
I don’t know where the writer got his info regarding the ease of obtaining a Durable Medical Equipment permit but especially over the last year CMS has made the certification and recertification so difficult especially for doctors that it boggles the mind. The average time from application until recertification is at least 6 months and always includes an on-site visit. Mind you, this is for a physicians office that has been participating for over 10-20 years AND bills out on average less than $5000 annually as MOST physician offices do. The surety bond mentioned would cost these physicians $3000 to $4k per year making their continued participation impossible.
And the numbers quoted in the story in terms of real fraud are ludicrous. Included in the Inspector General’s report is an estimate of physician fraud. This claim of fraud is not based on the fact that the physician did not examine the and/or treat the patient(indeed the patient is contacted less than 0.1% for confirmation) but is based on the wording on a physician’s note. One word that is not to their SUBJECTIVE liking and guess what, you and your claim are deemed fraudulent. That “fraud” is then extrapolated onto the amount of patient’s seen in the past 1-2 year time frame and voila you get headlines. BTW these retroactive audits are based on documentation requirements that change sometimes within one year AND are subject to the local CMS insurance carrier. So what language that may be illegal in California would be considered ok in Oklahoma or Virginia. And mind you, this is may be predicated on ONE word missing from a 250 word progress note.
UNREAL. But don’t worry folks, I’m quite sure that when we have the Demagogues install “universal health care” run by the gubmint there will be no more fraud b/c we will have arrived at a liberal Utopia.
I loved the Medicare hack bureaucrat who says she can’t do anything about this rampant, blatant fraud in S. Florida because Medicare’s budget for combatting fraud is “only” $720 million. Excuse me, if you cannot tackle the obvious #1 source of fraud in the land b/c your budget is ‘only’ $720 million, then you are far too incompetent to be allowed in any job at all. Oh, except of course if you are a gubmint hack bureaucrat.
Florida ping.
Also rampant in South Florida: insurance fraud, mortgage fraud and consumer fraud.
The media in South Florida is a fraud: print and broadcast—in the tank for the left. So are the 95% of the politicians. And the public schools.
People you see walking along Lincoln Road in Miami Beach: frauds.
You name the type of fraud, South Florida has it...
The prestigious "Dan Rather School of Journalism"..........where the facts are only bumps in the road to a preconceived agenda
Yeah, this little fraud in Texas made it difficult for anyone on MEDICARE to get wheelchairs for several months. Amazing how the feds can ignore obvious fraud for years then in a knee jerk reaction penalize the whole system when it is exposed.
I was in the home medical equipment biz at the time. If I remember correctly, 31,000 wheelchairs were billed to MEDICARE in Harris Co, Texas alone! ...and no one at MEDICARE seemed to notice.
http://www.click2houston.com/news/13799056/detail.html
Hey ease up! I’d like see you try to live on only 720 million! Geez!
“....I don’t know where the writer got his info regarding the ease of obtaining a Durable Medical Equipment permit but especially over the last year CMS has made the certification and recertification so difficult especially for doctors that it boggles the mind....”
Same thing for DME providers. It took my partners and me 8 months from application to approval and we were dam lucky to get it that quickly.
Then there are ADA regs, OHSA, Joint Commission, State Pharmacy Board, local permits for oxygen storage and transport, DOT, licensure, etc, etc. Billing is a whole nother ball of wax and God forbid your biller mis-codes something.
What boggled my mind was the ‘reinterpretation’ the Clinton Administration applied to so many of the regs. Suddenly, everyone in DME was illegal!
I am now in real estate, about to starve, but don’t have nearly the headaches or liability.
The Haitians were big on medicare fraud when I lived down there. I wonder if all of the Indians from Guatemala who do all the landscaping down there have picked up on Uncle Sugar yet.
You are correct....
Medicare is no different that the federal tax code...the regulations are so complex, that to be 100% compliant is impossible, and open to significant interpretation by the government themselves, who set the rules in the first place.
Most medical groups like mine have to hire ‘compliance specialists’ just to keep up with all the shifting rules and regulations, and pay out of pocket for internal audits conducted by outside agencies specifically looking at compliance....and we have to do all this for a subset of patients that provide the least amount of reimbursement..it’a all a big joke (on us).
This is why providers are limiting or dropping medicaid altogether, and it’s getting that way with medicare too.
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