Medicare Fraud/Abuse: Don’t Do It

Many of our readers are not health professionals, and they are observers of our (their) wounded health system.  The following stories such as these point out how sociopaths impact the federal budget, and directly reduce the ability of honest citizens to obtain medical care. Unlike non violent criminals their actions amount to an assault and sometimes indirect homicide on all of us.

Bolademi Adetola, owner of healthcare equipment provider Latay Medical Services in Gardena, was charged with billing Medicare for power wheelchairs that were never purchased. Greatcare Home Health in Los Angeles allegedly paid kickbacks to recruiters to find “patients” who were perfectly fine, and then have doctors knowingly write phony prescriptions for them.

Dr. Augustus Ohemeng and Dr. George Tarryk, who treated patients at the Pacific Clinic in Long Beach, were among four individuals who allegedly falsely billed for feeding tubes for patients who did not need them.

Lawrence Duran, the former owner of a mental healthcare company in Miami was sentenced last year to 50 years in prison. His two co-owners were sentenced to 35 years.”

In the Los Angeles area, eight people, including two doctors, were charged with fraudulently billing about $20 million for services never provided.

In addition, officials in the Health and Human Services Department suspended or took other administrative actions against 52 medical providers after analyzing billing requests and finding additional “credible allegations of fraud”.

Many home health, durable medical suppliers and physicians started yesterday with a full waiting room of federal agents, FBI, IRS and Medicare officials with subpoenas, and seizure warrants for records, computers and information regarding billing of Medicare. 

The Feds and Medicare have increased their power of investigation and enforcement using sting operations, whistle blowers and other clandestine operations. The War on Medicare Fraud and Abuse is underway. It is amazing how inventive Medicare embezzlers can become to siphon money from the U.S. Treasury.

Doctors, nurses and social workers from across the country, 107 in all, were charged in what federal officials in Washington called a “nationwide takedown” of medical professionals accused of fraudulently billing Medicare out of nearly half a billion dollars. Of the 107 defendants in the latest crackdown, 87 were arrested Wednesday. Federal agents were either still looking for the others or expecting them to surrender voluntarily.  In addition, officials in the Health and Human Services Department suspended or took other administrative actions against 52 medical providers after analyzing billing requests and finding additional “credible allegations of fraud.”

The amount of bogus Medicare claims, totaling about $452 million, was the highest in a single raid in the history of a federal strike force combating rising fraud in the medical industry, according to the Justice Department. Arrests were made in seven major cities.

The Obama administration said it was toughening its attack on those who filed bills for ambulance rides never taken and medical procedures never provided.

The funding for the increase in  enforcement is from a portion of the Health Reform Act (PPACA). It’s part of the 1200 page bill Congress did not read before passing it. It’s one section of the act that is in force…..now….and it can be retained if part of or all of the PPACA is disallowed by SCOTUS