Jump to content

Post-gazette keeps up the pressure on UPMC

News   (5,152 Views 18 Comments)
by oramar oramar (Member) Member

1 Article; 32,616 Profile Views; 5,758 Posts

You are reading page 2 of Post-gazette keeps up the pressure on UPMC. If you want to start from the beginning Go to First Page.

tewdles has 31 years experience as a RN and specializes in PICU, NICU, L&D, Public Health, Hospice.

3,156 Posts; 30,797 Profile Views

Indeed, medicare and medicaid are pretty efficient when compared to similar services provided by private companies...less % of the $ spent for "overhead" more of the $ spent on actual patient based service.

Fraud is problematic...sure, but you cannot blame medicare or medicaid for the greed and misconduct of those (largely for profit) entities who are billing for services not rendered.

Share this post


Link to post
Share on other sites

herring_RN specializes in Critical care, tele, Medical-Surgical.

3 Followers; 2,930 Posts; 98,299 Profile Views

indeed, medicare and medicaid are pretty efficient when compared to similar services provided by private companies...less % of the $ spent for "overhead" more of the $ spent on actual patient based service.

fraud is problematic...sure, but you cannot blame medicare or medicaid for the greed and misconduct of those (largely for profit) entities who are billing for services not rendered.

one example:

in april the us department of justice announced that cvs pharmacy inc., the retail pharmacy division of cvs caremark corporation that operates more than 7,000 retail pharmacies in 41 states and the district of columbia, has agreed to pay the united states and 10 states $17.5 million to resolve false claims act allegations related to medicaid billings for prescription drugs.

 

"medicaid covers the poorest, most vulnerable people in american society. overcharging this needed government program for prescriptions is a disservice to everyone, and won't be tolerated," said daniel r.

levinson, inspector general of the u.s. department of health & human services. "oig will work vigilantly with law enforcement partners at all levels of government to safeguard this vital program."

 

here is a link to the complete usdoj news release: http://go.usa.gov/td5

another:

us justice department announced that bluecross blueshield of illinois, a division of health care service corporation, had agreed to pay the united states and the state of illinois $25 million to settle false claims act allegations. the settlement resolves claims by the united states that bluecross blueshield of illinois wrongly terminated insurance coverage for private duty skilled nursing care for medically fragile, technologically dependent children, in order to shift the costs of such care to the medicaid program. medicaid funds a special program designed to provide home care for children at risk of institutionalization.

"private insurance companies that deny properly payable claims in order to inappropriately shift costs to federal health care programs -- as bc/bs of il is alleged to have done - will be held accountable," said daniel r. levinson, inspector general of the department of health & human services. "oig, along with our federal and state partners, will continue to protect patients and taxpayers by prosecuting those behind these schemes."

the complete news release is available online at http://go.usa.gov/gar

another:

the medicare fraud strike force charged 111 defendants in nine cities, including doctors, nurses, health care company owners and executives, and others, for their alleged participation in medicare fraud schemes involving more than $225 million in false billing, announced attorney general eric holder, health and human services (hhs) secretary kathleen sebelius, fbi executive assistant director shawn henry, assistant attorney general lanny a. breuer of the criminal division and hhs

inspector general daniel levinson.

also today, the department of justice (doj) and hhs announced the expansion of medicare fraud strike force operations to two additional

cities - dallas and chicago. today's operation is the largest-ever

federal health care fraud takedown.

"today, more than 300 special agents from oig, in partnership with federal and state agencies across the country, are making more than a hundred arrests on charges of health care fraud," said daniel r.

levinson, hhs inspector general. "these unprecedented operations send a clear message - we will not tolerate criminals lining their pockets at the expense of medicare patients and taxpayers."

the complete news release is available online at http://go.usa.gov/g86

Edited by herring_RN

Share this post


Link to post
Share on other sites

2 Followers; 14,620 Posts; 103,778 Profile Views

The precious government officials frankly could care less as they don't have to contribute to Social Security and once they serve a term or two they have 100% health insurance and their salary for LIFE!!!

Ths is not true (and it hasn't been for a long time). Members of Congress do pay into and receive Social Security, same as (nearly) everyone else, and they are covered by the same healthcare and retirement benefits as every other Federal employee, from the president and his family down to the individuals mopping the floors at the VA or typing and filing at your local Social Security office.

There's plenty to get upset about about the way the government functions, but don't waste your time getting upset about stuff that isn't happening ... :)

Share this post


Link to post
Share on other sites

991 Posts; 15,088 Profile Views

I live for the day to see all the hospital systems CEO's in our country rounded up, put in a paddy wagon, carted off to federal prison, and have all their salted away multi millions given over to "Nurse House" to help us old baby boomers nursing no longer wants-- SHARE THE FANTASY.

Share this post


Link to post
Share on other sites

KittyLovinRN has 5 years experience and specializes in Pulmonary, Lung Transplant, Med/Surg.

125 Posts; 3,835 Profile Views

I am an employee AND patient of UPMC.

I work full time, receiving full time benefits and also see a urologist twice a year and approximately once a year am a patient of a renal stone procedure.

While I was not all that surprised by the article (I wish I were), I also find it impossible to ignore the excellent care I've received at Presby/Montefiore during my ambulatory surgery days. I actually do believe that UPMC attracts the brightest bulbs in the box, I've got living proof of two immaculate urologic surgeons in my chart.

I just get a little annoyed when people bash their employer, if it's THAT bad, then leave. I won't sit here and lie about being annoyed at where I see the money going but knowing that my relatively small healthcare payment that comes from each paycheck is buying me really excellent healthcare, I'll gladly keep my mouth shut.

Share this post


Link to post
Share on other sites

991 Posts; 15,088 Profile Views

I am speaking for myself- I am in no way acusing and certainly not bashing the doctors,nurses or other HEALTHCARE professionals of not giving their all. Which I truely beleive they do. My problem and contempt is for the FISCAL employees (CEO, financial directors, the bean counters) who are so blatently corrupt and diverting money from a healthcare system, any healthcare system for that matter, all the while they cut the day to day hands on s staff that actually are legally responsible and trying like hell to keep patients safe and alive. The over inflated salaries, the nepotism the spending frenzy on pure self entertaining, titilating indulgents of season tickets to professional ball games- they are NOT sitting in bleachers- they are sitting in club seats- those ARE NOT CHEAP!! They place that as a priority over what you and your colleges do 12hr/day, day in and day out, 24/7. That is totally uncalled for and way, way out of line. It's so out of line, it's sick. Do you honestly think those FICICAL employees realy have any comprehension or appreciationfor what you do? They are monsters, How they can crasly and vulgarly,boldly sit- suck down beer and hot dogs knowing they have cheated thousands of patients out of the diligent attention and care THEY are paying for by not supplying adequate staffing. I see you post 2 yr experience, so these horrific staffing levels are all you have ever known in your career. You came into nursing in the eye of the storm. Us older nurses- remember a time when staffing was not dangerous. True, our patients were not as acutely ill so all the more reason to INCREASE, step UP staffing levels.

The PTB do not want to hear this. This is a major reason why these PTB want us older experienced nurses out. We know how things should be and why they should be that way. We can write the case study on compare and contrast. These PTB have gone out of thir way to manipulate the current nursing wages, they are manipulating the hiring/job market. They do not want us older experienced nurse putting ideas into new to nursing nurses heads. Nurses were not always kicked to curb- this is something new(past 5-7 yrs) Nurses were not fired, cohersed into resignation for the things they are today(documentation,charting, tardiness, call outs, speaking their mind)- Mistakes were not happening as frequently and to the magnitude they are today- we had more staff! These FISCAL employees are treating healthcare- nurses, doctors and other healthcare depts, like it was a retail store cutting down on the number of sales/floor personal, checkout lines and cashiers! If they can erase the memory- who, new in their career, is going to know the difference when all you know is working short and dangerous!! Where's that old biddy nurse coworker whose going to come up behind you and save YOU from the near misses. Those near misses turn into sentinel events. The missed MI who dies in the waiting room or is found in the bed, the unrecognized stroke or aneurysm sent home, the medication adverse interaction, the septic.

These PTB have placed you(and the patient) in a very vulnerable position. These PTB do not have your education preperation/foundation to know just what they have done. The newer nurses have an epiphany after 2-3 yrs and get out of dodge and don't look back after a few shifts of personal palpatations and v tach of their own. There is no old biddy for them to go to and think out loud to. And this is all done, for MONEY/PROFIT so some crackhead CEO and his cronies can enjoy club seats at a ballgame. They get their salaries first/off the top. If profits are down- they see no decrease in pay- they cut staff you the nurse and the end user of that action is the patient( you mother, sister, father, aunt, infant neice or nephew etc) Never has any profit been put back into patient care. There are NO unpaid patient bills. Charity care pays for self pay aka no insurance patients. The funding for charity care comes from the state government revenues. Revenues are from taxpayers. The hosptial gets it's money- always. when it looks like the hosptal profits will be3 down, the hospital raises it's room rates- The insurance compaies tell the hospital togo poop in their bonnets because if the insurance companies keep giving into to these hospital extortionists, the insurance companies will have no one buying their insurance- too expensive. Now the talk is get rid of all the nurse and use UAP. Some one is smoking something.This is the most blatant disregard of human life there is. Get these CEO's out of there.

Share this post


Link to post
Share on other sites
×