Tuesday, December 28, 2010

Report Scams... It's Your Duty

I have been reporting that Medicare has more than sufficient dollars available to take care of those people who qualify. I also believe that for every legitimate buck spent another additional dollar is stolen from the system. So the object is to get the crooks out.

The largest scam I’ve seen was the Hospital Corporation of America, which paid a fine of about $7.5 million. This may be the highest fine ever levied for Medicare fraud.

Well, the thieves who sell drugs or by other nefarious means for “making a living,” usually end up in jail when they get caught. But when they see the president of a company that paid a gigantic fine was able to save enough money to become elected a governor of a state, they try to play “Can You Top This.” Today, I read of another scam.

A group of gangsters set up a national “franchise” for their associates using phantom health clinics. Information was garnered in New York. They stole the IDs of physicians (some dead) and merrily submitted bills to Medicare for services rendered (I assume their major expense was postage). They set up 118 clinics in 25 states! In New York alone, they submitted invoices for $100 million and Medicare has already paid out more than $35 million.

We have not seen the dollar figures for other states, but this is what you, HME providers, have to watch for. You must report any of this you suspect. The police, the prosecutors and the FBI will follow up. This raping of the system must be stopped. This is the chicanery that has lead to the competitive bidding legislation. It is why Medicare does not have sufficient money to reimburse hard working providers.

If you would like to speak about any local problems, please e-mail me at shelly.prial@att.net or call me at (877) 553-5127. I have had conversations with a number of providers about this problem. Protect your business and your employees – and never forget you have to protect your clients.

For more information on Medicare fraud, please visit: www.mymedicarefraudreporting.com

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