Saturday, July 29, 2017

Extending Medicare?

One of the oft-stated hopes of Obamacare supporters if the GOPe ever decides to do what they have promised to do for years, repealing Obamacare, is to expand Medicare or Medicaid to cover all the uninsured.  One problem with this fairly benign proposal is the numerous news stories like these which popped up on for "medicare fraud"; I was afraid to enter "medicaid fraud":
These 10 people assisted in a million-dollar Medicare fraud. Now they’re paying for it
Ten owners of Miami-Dade assisted living facilities were sentenced last week for their role in a Medicare fraud scheme by the owner of Hialeah’s Florida Pharmacy. Most received a year and a day in federal prison followed by three years of supervised release.
Each ALF owner sentenced by U.S. District Judge Marcia G. Cooke last week assisted pharmacy owner Maria Serrano in a million-dollar scam that used patients as pawns.
In court documents, Serrano admitted to paying kickbacks to the ALF owners for sending Medicare or Medicaid receiving residents to Florida Pharmacy for prescriptions and durable medical equipment. The ALF owners also would return to Serrano any unused prescription drugs already paid for by Medicare or Medicaid. Serrano would resell those drugs and submit false claims to Medicare and Medicaid.

Vanderbilt hospital to pay millions over Medicare fraud allegations

Vanderbilt University Medical Center is paying $6.5 million to settle a yearslong case over Medicare fraud allegations. 
Three physicians formerly employed by the health system claim that VUMC's surgery scheduling practices from 2003 to 2011 violated Medicare billing regulations. The case was filed under seal in 2011 and became public in 2013.
Neither the federal government nor the state government intervened in the process. But under the False Claims Act, Medicare will receive most of the money from the settlement. Some will go to state agencies. Whistleblowers also receive a portion of settlements. 
Evans can rightly claim big win in Medicare-fraud case
Rep. Stacey Evans, D-Smyrna, is running for governor of Georgia, and she’s touting a major Medicare fraud case she argued with her private law practice in a campaign video.
She argued a civil lawsuit she argued alongside three other firms representing the U.S. government against DaVita HealthCare Partners Inc., a leading provider of dialysis services in the United States. They represented two whistleblowers.
The lawsuit alleged that DaVita was knowingly generating unnecessary waste when administering drugs to dialysis patients, then billing Medicare for the waste.
The company did not admit wrongdoing, but paid $450 million in settlements to resolve the claims.
Cuban at center of massive Medicare-related money-laundering case arrested in Spain
A Cuban businessman wanted in Miami for the past five years in one of the nation’s biggest Medicare-related money-laundering cases was arrested in Spain on Friday, authorities said.
Jorge Emilio Perez de Morales, who was indicted in 2012 on a conspiracy charge of laundering $238 million in illicit Medicare payments through South Florida, is expected to seek a bond in Spain and challenge his extradition to the United States.
Man Accused in $132 Million Medicare Fraud Scheme Is Building $6.8-Million Home
 Greed is often the great motivator in multi-million dollar Medicare fraud cases.
Now, meet health care executive Mashiyat Rashid, 37, of West Bloomfield, who is accused of being very greedy and orchestrating a $132 million Medicare fraud scheme. 
Authorities allege that he blew money on courtside NBA tickets, stuffed secret storage units with cash and is currently building a $6.8 million home in Franklin that includes an indoor subterranean basketball court, according to Robert Snell of The Detroit News. As part of the suspected scheme, prosecutors allege that he recruited homeless people as patients, sent phony bills to Medicare, subjecting drug addicts to unnecessary back injections and prescribed powerful pain medication that ended up being sold on the street.
"This was a crime of deceit. His fraud was brazen," Justice Department trial attorney Jacob Foster said Wednesday during Rashid’s bond hearing. "This was about the thousands and thousands of beneficiaries who were taken advantage of in order for [Rashid] to line his pockets."
Texas Co. Owner Gets 4 Years In $374M Medicare Scam
Law360, Dallas (July 26, 2017, 4:27 PM EDT) -- A Texas federal judge on Wednesday sentenced a home health care company owner convicted of health care fraud to four years in prison, rejecting an argument from prosecutors that her role in an alleged $374 million Medicare fraud scheme merited a harsher sentence. 
Charity Eleda, 56, has already spent 15 months in county jail after her April 2016 conviction for taking part in what federal prosecutors describe as one of the largest health care frauds in the country. Eleda was allegedly part of a scheme run by Dr. Jacques Roy through which he certified 11,000 patients for unnecessary home treatments through Medicare.
Eleda, a registered nurse and co-owner of Charry Home Care Services Inc., was convicted of conspiracy to commit health care fraud, four counts of health care fraud and three counts of making false statements. She’s accused of recruiting patients for purported home care at a Dallas homeless shelter, even paying a man she knew was addicted to drugs to recruit other homeless people to visit her for treatment. 
Do private insurance companies get scammed?  Of course.  But it isn't taxpayer money going to those crooks.  Anytime you have huge wads of money available, it attracts scum.

1 comment:

  1. Much is made about how less money goes towards administrative costs in Medicare as compared to private insurance companies. If Medicare truly wished to stop this embezzling before it got into the hundreds of millions of dollars, its administrative costs would go up to be comparable to the administrative costs of private insurers.