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Justice department arrests 91 doctors, nurses, and medical professionals in $430M Medicare fraud
The Daily Mail ^ | October 4, 2012 | Beth Stebner

Posted on 10/04/2012 1:59:32 PM PDT by Uncle Chip

Called largest Medicare fraud takedown in history of program

Medicare Fraud Strike Force targeted seven cities: Brooklyn, Baton Rouge, Chicago, Dallas, Houston, Los Angeles, and Miami

In Miami, 33 suspects were charged with more than $200m of fraud

(Excerpt) Read more at dailymail.co.uk ...


TOPICS: History
KEYWORDS: fraud; medicare; medicarefraud

1 posted on 10/04/2012 1:59:40 PM PDT by Uncle Chip
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To: Uncle Chip
We could probably save 10X that amount if the SSDI, welfare EBT, Food Stamps, etc. were investigated THOROUGHLY for abuse and fraud.

Of course, The Messiah would not mess with his voterbase.

2 posted on 10/04/2012 2:07:04 PM PDT by traditional1 (Don't gotsta worry 'bout no mo'gage, don't gotsta worry 'bout no gas; Obama gonna take care o' me!)
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To: Uncle Chip

Here’s the thing. Once you get arrested as a doctor in episodes like this....your clinic gets shut down. You shut the doors, and still hidden in your house...awaiting legal wrangling by your attorney. Negotiation takes place. You keep hoping to avoid a federal conviction, which would take down your license to be a doctor. If you get jail time....it means typically a minimum of one year in prison, and you will likely not get your license back.

In my home town in Bama...we had a local female doc who got into fraud charges and arrested. Her ex-husband was a lawyer and had been working with her to run the fraud operation. I don’t think she made more than $100k a year off this but obviously, if you’ve done this four or five years...they can’t just allow you to walk away. She’s probably to pay a heavy fine and just avoid jail or convictions.

Who takes their place, to help the new incoming folks who get Obama-care? No one. It just tightens up the new mess a little bit more.


3 posted on 10/04/2012 2:09:52 PM PDT by pepsionice
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To: Uncle Chip

Here’s the thing. Once you get arrested as a doctor in episodes like this....your clinic gets shut down. You shut the doors, and still hidden in your house...awaiting legal wrangling by your attorney. Negotiation takes place. You keep hoping to avoid a federal conviction, which would take down your license to be a doctor. If you get jail time....it means typically a minimum of one year in prison, and you will likely not get your license back.

In my home town in Bama...we had a local female doc who got into fraud charges and arrested. Her ex-husband was a lawyer and had been working with her to run the fraud operation. I don’t think she made more than $100k a year off this but obviously, if you’ve done this four or five years...they can’t just allow you to walk away. She’s probably to pay a heavy fine and just avoid jail or convictions.

Who takes their place, to help the new incoming folks who get Obama-care? No one. It just tightens up the new mess a little bit more.


4 posted on 10/04/2012 2:10:15 PM PDT by pepsionice
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To: Uncle Chip

Do you think this was politically motivated timing?


5 posted on 10/04/2012 2:16:30 PM PDT by tbw2
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To: tbw2; pepsionice
I used to applaud these arrests but with ObamaCare and the tightening of regulations and the plethora of paperwork that carries criminal charges for filling out the wrong box, I am not so sure anymore. And why now???

Why would any physician want to deal with Medicare for as little as it pays???

6 posted on 10/04/2012 2:25:39 PM PDT by Uncle Chip
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To: Uncle Chip

And, OBAMACARE will DUPLICATE the way Medicare operates TIMES 100! Fraud will be rampant.


7 posted on 10/04/2012 2:26:46 PM PDT by goodnesswins (What has happened to America?)
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To: Uncle Chip

8 posted on 10/04/2012 2:31:45 PM PDT by JoeProBono (A closed mouth gathers no feet - Mater tua caligas exercitus gerit ;-{)
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To: Uncle Chip

Preview to Obamacare


9 posted on 10/04/2012 2:58:54 PM PDT by AngelesCrestHighway
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To: Uncle Chip

Most physicians no longer work in solo practice and the hospital or clinic they work for usually takes Medicare patients. Being qualified to receive Medicare reimbursements is very important to maintaining incomes and private insurance companies tend to look at Medicare approval as a surrogate validation. If you are removed from Medicare reimbursement eligibility, the private insurance companies will drop you from eligibility, too. At least that’s how it works in this neck of the woods. The docs around here care very very much about Medicare even if they rarely see a Medicare patient.


10 posted on 10/04/2012 3:42:47 PM PDT by iacovatx (Conservatism is the political center--it is not "right" of center)
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To: Uncle Chip

Obama and company took more out of Medicare.


11 posted on 10/04/2012 3:51:23 PM PDT by freekitty (Give me back my conservative vote; then find me a real conservative to vote for)
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To: Uncle Chip

Most fraud (real fraud) involves minority communities and is too hard for the Feds to prosecute, for a number of reasons.

Pseudo-fraud, OTOH (failure to adhere to all 70 000 pages of the constantly changing regulations) is easy to prosecute, since under administrative law accused parties are guilty until proven innocent, and technical violations are easy to find in every practice.

Then there are “frauds” like charging for a consultation after Medicare declared 2 years ago that they would not recognize consultations any more. Consultations, you know, when a primary care doctor calls a specialist to see you?

So, Medicare decreed that when a doctor does a consultation for a Medicare patient, he must bill instead for a routine hospital or office visit (because the Feds don’t recognize consultations anymore). Or, I suppose, you could do it for free.

This has created thousands and thousands of charges that are arguably “fraudulent”. Obviously, when I do a consult, the medical record has to reflect 1) that I was asked to do it; 2) what my opinion is; 3) what I recommend; and 4) the discussion I had with the referring doctor. The problem is, this note does not meet Medicare criteria for a routine visit.

So, in theory, any “routine visit” charges since 2011 that are really for consultations could be prosecuted as fraud.


12 posted on 10/04/2012 4:07:00 PM PDT by Jim Noble (Diseases desperate grown are by desperate appliance relieved or not at all.a)
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