Thursday, October 22, 2009

Doing The Job

Now, here's a story that put the crunch back in my corn flakes this morning. Federal and local governments got their crime fighters on the same page and busted twenty Californians for Medicare fraud.

Federal officials have charged 20 people with fraudulent Medicare billing in seven cases that total $26 million in unneeded or undelivered medical equipment, the U.S. attorney's office in Los Angeles said Wednesday.

The charges came out of a joint investigation by the FBI, U.S. Department of Health and Human Services and California attorney general's office.
[Emphasis added]

Most of the cases involve motorized wheel chairs that were never delivered, but at least one of the seven cases involved illegal payments for referrals to a couple of clinics. Those clinics are neither named nor described, but I suspect that they are what are known in my business as "mills." Patients come in, are ushered from doctor to doctor up and down the hall, no area of specialization omitted, and expensive tests (usually done on site) and expensive treatments are prescribed regardless of the complaints the patient might have come in with. Then Medicare is billed. But at least the patients are seen, even if only once.

It's those wheel chairs and other medical equipment which were (and ought to be) the primary target of this particular investigation. Some of the companies exist only on paper, have no inventory, no showroom, not even a working telephone number. Once these crooks have the social security number of an elder over 65, the rest is easy. A dummy prescription attached to the bill for a $3,000 wheelchair usually does the trick.

This investigation (which might have cost a total of $1 million, at most) uncovered more than 25 times that in fraud, and this is in just one sweep in one state. Think of the savings to Medicare if all the states' attorney generals and US attorneys cooperated on a regular basis to root out these criminals. With enough publicity, that's exactly what the doctor ordered when it comes to keeping Medicare healthy.

This investigation is one use of taxpayer money I think is appropriate.



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