Healthcare professionals charged with Medicare Fraud | allnurses

Healthcare professionals charged with Medicare Fraud

  1. 1 http://news.yahoo.com/91-charged-med...185626753.html

    According to the article, it looks like 4 (total) nurses were included in the 91. Apparently spread across the 91 people, Medicare was billed for nearly $300 Million. Yikes! I realize that this is nothing new but that is still a scary amount of our tax dollars going to the pockets of greedy people that are not likely even trying to help their patients. I sincerely hope that some of that money actually went to patient care.

    I'm particularly disgusted that they (some of the fraudsters) picked medicare recipients, put them in a halfway house, and "blackmailed" them into saying they were receiving services that they were not getting.
  2. Visit  SomedaySoonNY profile page

    About SomedaySoonNY

    From 'WNY'; Joined Sep '11; Posts: 10; Likes: 3.

    12 Comments so far...

  3. Visit  Hospice Nurse LPN profile page
    1
    One of the docs stated he was doing "group therapy" ----- the pts had dementia.

    7 of the people charged were w/ 2 companies in my state.

    Really, really sad.
    lindarn likes this.
  4. Visit  DoGoodThenGo profile page
    3
    Quote from SomedaySoonNY
    http://news.yahoo.com/91-charged-med...185626753.html

    According to the article, it looks like 4 (total) nurses were included in the 91. Apparently spread across the 91 people, Medicare was billed for nearly $300 Million. Yikes! I realize that this is nothing new but that is still a scary amount of our tax dollars going to the pockets of greedy people that are not likely even trying to help their patients. I sincerely hope that some of that money actually went to patient care.

    I'm particularly disgusted that they (some of the fraudsters) picked medicare recipients, put them in a halfway house, and "blackmailed" them into saying they were receiving services that they were not getting.
    Three hundred millon is barely the tip of the iceberg.

    According to a news report I saw the other night anywhere from 2% to 3% or a bit more of each Medicare dollar spent goes to fraud. When you look at the billions spent on the program each year that is a vast amount of money being "misdirected".

    FWIU the way Medicare and to an extent Medicaid currently is set up make them an open target for fraud and abuse.
    lindarn, Esme12, and cherryames1949 like this.
  5. Visit  NRSKarenRN profile page
    2
    full info can be found at: home | stopmedicarefraud.gov
    herring_RN and lindarn like this.
  6. Visit  Esme12 profile page
    2
    After all these years and billions of dollars stolen....can no one in the government watch dog agencies stop this???? Only 91 people, $300 MILLION, gone........yet the government want to cut services to those who need it most because these predators get a way with STEALING BILLIONS of dollars.

    Some one needs to held accountable
    herring_RN and lindarn like this.
  7. Visit  cinderblockdee profile page
    0
    Currently I do chart audits for various state run health plans. One office I went to was in a zip code that I was dumbfounded that it would have any medicaid patients at all, just the interior of the office decor was enough to throw up a fraud signal.
    Patient receiving government sponsored care, living in a neighborhood that the lowest priced home would be 2 million dollars. Everyone in this family was receiving free health care.

    Another fraud laced practice is immigrant dense populations. Senior aged patients within weeks of arrival into US receiving medicare, never worked here, never lived here, but now arrived and receiving benefits.
  8. Visit  DoGoodThenGo profile page
    0
    Quote from cinderblockdee
    Currently I do chart audits for various state run health plans. One office I went to was in a zip code that I was dumbfounded that it would have any medicaid patients at all, just the interior of the office decor was enough to throw up a fraud signal.
    Patient receiving government sponsored care, living in a neighborhood that the lowest priced home would be 2 million dollars. Everyone in this family was receiving free health care.

    Another fraud laced practice is immigrant dense populations. Senior aged patients within weeks of arrival into US receiving medicare, never worked here, never lived here, but now arrived and receiving benefits.
    In NYC one area, Brighton Beach in Brooklyn with it's large Russian immigrant population has, IIRC the highest Medicaid fraud rate in the city. And that is only those who have been found out, tried and convicted. Which means pretty much the tip of the iceberg.

    Not wishing to cause offence or sound rude, but when Medicare fraud is discussed here in NY it is not the usual persons one suspects. Rather the Jewish and Russian immigrant communities is where things often happen.

    One theory goes after having lived under the harsh conditions of Russia, these persons know a thing or two about how to work a system towards their favour.
  9. Visit  Rodoon profile page
    1
    This could be a new field for nurses to work in. A nurse would pick up hints that something wasn't right in listed treatments way faster than most like cinderblockdee mentioned. Problem is the states have budget woes. Stopping fraud would more than pay for the positions IMO. I remember a patient in my hospital getting paid by other patients and their family's to show them how to cut through red tape on disability. Now long after lawyers got in the business.
    Not_A_Hat_Person likes this.
  10. Visit  herring_RN profile page
    0
    it seems wherever and whenever there is money involved some dishonest criminal tries to get it. -- criminal and civil enforcement | fraud | office of inspector general | u.s. department of health and human services
    [color=#242424]physician sentenced to more than six years in federal prison for role in massive medicare fraud scam

    [color=#242424]thursday, july 12, 2012

    [color=#242424]sacramento, calif.-lana le chabrier, 64, of santa barbara, was sentenced today by united states district judge morrison c. england jr. to six and a half years in prison for conspiring to commit health care fraud. she was found guilty by a jury on july 8, 2011.

    in sentencing le chabrier, judge england found that she abused her position of trust as a physician and was responsible for close to a million dollars in fraudulent billings submitted to medicare and more than $400,000 in payments made on false claims. following her arrest and prior to trial, le chabrier attempted to flee the united states and was apprehended at the canadian border with $55,000 in cash, an expired united states passport (she was required to surrender her valid passport upon her arrest), and a bottle of hair dye. judge england found the attempted escape to be an obstruction of justice. ...
    [color=#242424]... [color=#242424]in fact, le chabrier never treated a single patient at the clinic. ...

    [color=#242424]usdoj: us attorney's office - eastern district of california
  11. Visit  Esme12 profile page
    1
    Like everything else today....greed.
    herring_RN likes this.
  12. Visit  herring_RN profile page
    0
    [color=#990000][font=&amp]captured:[font=&amp] enrique gonzalez

    [font=&amp]enrique gonzalez figueredo was extradited to the united states from peru early this morning by the united states marshals service.

    [font=&amp]investigators believe that gonzalez and his co-conspirator billed medicare for over $26 million for medical services that were not provided or were not necessary.

    captured fugitives | oig most wanted fugitives | fraud | office of inspector general | u.s. department of health and human services
  13. Visit  DoGoodThenGo profile page
    0
    Whole thing is as currently designed both Medicare and Medicaid are ripe for abuse and fraud. While federal and local governments have gotten better at finding and dealing with fraud and waste, still more, so much more goes undetected.
  14. Visit  herring_RN profile page
    0
    Jury rules Tuomey Healthcare violated Stark in claims worth $39M
    After a four-week do-over trial, a jury concluded Thursday afternoon that Tuomey Healthcare System in Sumter, S.C., violated the False Claims Act by submitting tens of thousands of illegal bills to Medicare worth $39 million.

    The 10-person jury agreed with prosecutors and a physician whistle-blower in the highly charged case, finding that the hospital was paying doctors in ways that rewarded them financially for referring patients to the hospital, violating both the Stark law and the False Claims Act. ...

    ...
    Jurors found that Tuomey submitted a total of 21,730 Medicare claims that were tainted by illegal compensation arrangements.

    Tuomey lawyers have said a finding of False Claims Act liability could be financially catastrophic for the 242-bed community hospital.

    The hospital's ultimate financial penalty is not yet decided. Federal law would require repayment of all of the money paid under illegal Medicare claims, and the False Claims Act allows the government to try to reclaim up to triple the amount of total damages, plus as much as $11,000 per claim. ...

    http://www.modernhealthcare.com/arti...paign=mh-alert





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