Democrats want everyone else to pay for the health care

....Asked why it has taken Medicare so long to figure out they were being scammed, Holder told Kroft, "I think lack of resources probably. And then I think people I don't think necessarily thought that something as well intentioned as Medicare and Medicaid would necessarily attract fraudsters. But I think we have to understand that it certainly has."

The Obama administration is providing Medicare with an additional $200 million to fight fraud as part of its stimulus package, and billions of dollars to computerize medical records and upgrade networks, which should help Medicare catch more phony charges....

Washington, DC - Eight Miami-Dade County, Florida residents have been indicted in connection with an alleged $22 million Medicare fraud scheme operated out of Miami businesses purporting to specialize in home health care services, announced Assistant Attorney General Lanny A. Breuer of the Criminal Division, Acting U.S. Attorney Jeffrey H. Sloman of the Southern District of Florida, and Daniel R. Levinson, Inspector General of the Department of Health & Human Services (HHS). . A temporary restraining order freezing assets of the indicted defendants and their companies was also filed.

As reported last week, the Medicare Fraud Strike Force has been cracking down on doctors, health care executives, and beneficiaries for alleged fraudulent Medicare billing. This renewed effort to reduce fraud and recover stolen taxpayer funds was announced in May of this year, as a joint effort between the Department of Justice and Health & Human Services. The Health Care Fraud Prevention & Enforcement Action Team (HEAT)—of which the Medicare Strike Force is part—conducted its first big sweep in Detroit, Michigan where 53 indictments were handed down by a grand jury that led to arrests.

This week similar indictments were made in Miami, Florida, where an estimated $22 million in fraud has been alleged. Eight arrests were made in connection with the fraud scheme that involved two home health care services: ABC Home Health Care, Inc. and Florida Home Health Care Providers. According to the official statement issued by Health and Human Services, “Both ABC and Florida Home Health purported to be home health agencies that catered to Medicare beneficiaries. The indictment alleges that at both agencies, beneficiaries were recruited and paid kickbacks and bribes to arrange for their Medicare beneficiary numbers to be used by their co-conspirators to file claims with Medicare for purported home health care services. The indictment alleges that the services were not provided and were not medically necessary.”

...The HEAT team will include senior officials from DOJ and HHS who will build upon and strengthen existing programs to combat fraud while also investing new resources and technology to prevent fraud, waste and abuse before it happens. Efforts will include the expansion of joint DOJ-HHS Medicare Fraud Strike Force teams that have been successfully fighting fraud in South Florida and Los Angeles. Established in 2007, these teams have a proven record of success using a “data-driven” approach to identify unexplainable billing patterns and investigating these providers for possible fraudulent activity. The Medicare Fraud Strike Force team operating in South Florida has already convicted 146 defendants and secured $186 million in criminal fines and civil recoveries. After the success of operations in South Florida, the Medicare Fraud Strike Force expanded in May 2008 to phase two in Los Angeles, where 37 defendants have been charged with criminal health care fraud offenses. To date in the Los Angeles cases, more than $55 million has been ordered in restitution to the Medicare program....

I just love the title of this thread...really thought that maybe Hannity or Limbaugh was the author.

I love this country and I am saddened by the animosity that the political parties are intent on creating, growing, and sustaining. I am sick to death of "talking heads" filling the minds, hearts, and souls of the public with the "us against them" attitute that is pervasive amongst out elected and seriously ineffective officials. Geez...the politicians are really polarized and it has not improved their performance...why would we think that we should follow suit as citizens?

The bottom line is this....everybody else is already paying for healthcare. I pay for it in taxes, in the cost of a bandaid in the ER, in the cost of my insurance premiums (oh wait, at least 20% of that money goes directly to "overhead" like bonuses for keeping claims down), and in the $300 prescription that is advertised on prime time tv and in full page glossies. And even tho I pay for it, I still have insurance companies decide which doctor I can see, what hospital I can use, what meds they will pay for, what surgery or treatment is best for me. They often get to decide what is a pre-existing condition and what is not. Trust me...an actual diagnosis or treatment plan written somewhere in the patient chart is not required for them to deny coverage based upon this "condition". So...I would say that "everyone else" paying for healthcare is our current state of affairs and is not working very well.

Many surgeons and others contributed over hundreds of years to create innovative approaches to surgery.

http://www.mssm.edu/misc/history.shtml

Asked why it has taken Medicare so long to figure out they were being scammed, Holder told Kroft, "I think lack of resources probably. And then I think people I don't think necessarily thought that something as well intentioned as Medicare and Medicaid would necessarily attract fraudsters. But I think we have to understand that it certainly has."


Medicare Fraud: A $60 Billion Crime - 60 Minutes - CBS News


In FLA and few other states, Medicare is requiring Durable Medical Equipment companies to reapply as providers.


June 27 2009:
Medicare Fraud Scheme Involving Home Health Care Agencies Participants Indicted




Alerts & Outbreaks - Another Strike Against Medicare Fraud Made in ...





Attorney General Holder and HHS Secretary Sebelius Announce New Interagency Health Care Fraud Prevention and Enforcement Action Team



New FLA state laws went into effect July 09 restricting Home Health Agencies from sprouting up in certain areas and strenthening laws against kickbacks, renumeration etc In few FLA counties, home health agency's have had to reapply for license - Memo on 2009 law changes for home health agencies


All these efforts by government have been kicked up few nothes over past 2 years as scope of problem identified. Getting everyone on EMR will help pinpoint areas huge billing and fraud for review.

You are right...insurance companies do lessen the time you spend in the hospital....several years ago they told my husband that they wouldn't pay for his surgery or hospitalization for bowel obstruction...that certainly reduced the time he spent there. Some might want to portray insurance companies as altruistic health institutions, really they are just big money machines that have changed the way we carry out healthcare in america...not because the ways are better for people/patients..but because they are more profitable. The insurance companies have been in the business, for some time, of making choices about the health care that their customers receive, or do not receive, based upon profitability for the company. That is not good healthcare. Those who fear reform cry that the government will ration care...ok...but in the two government health systems...Medicare and VA...where is this rationing? Our insurance companies do that.