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New York Medicaid Fraud May Reach Into Billions
The New York Times ^ | July 18, 2005 | CLIFFORD J. LEVY and MICHAEL LUO

Posted on 07/17/2005 10:43:41 PM PDT by cyborg

New York Medicaid Fraud May Reach Into Billions * E-Mail This * Printer-Friendly * Single-Page * Reprints By CLIFFORD J. LEVY and MICHAEL LUO Published: July 18, 2005 It was created 40 years ago to provide health care for the poorest New Yorkers, offering a lifeline to those who could not afford to have a baby or a heart attack. But in the decades since, New York State's Medicaid program has also become a $44.5 billion target for the unscrupulous and the opportunistic. Skip to next paragraph Andrea Mohin/The New York Times A barker lured customers to Dr. Dolly Rosen’s Brooklyn office, which had extraordinarily high Medicaid billings. This is the first of a series of articles that will examine the security, the effectiveness and the cost of New York's Medicaid program, the largest of its kind in the nation and the state's biggest expense.

(Excerpt) Read more at nytimes.com ...


TOPICS: Culture/Society; Front Page News; News/Current Events
KEYWORDS:
log-in using: Account #1 chadwit 1insipid

This is an absolute outrage. When will this crap end!

1 posted on 07/17/2005 10:43:41 PM PDT by cyborg
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To: cyborg
This is an absolute outrage. When will this crap end!

That's up to the Republicans. Democrats LOVE programs like Medicaid.

2 posted on 07/17/2005 10:46:46 PM PDT by Lancey Howard
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To: Lancey Howard

That's up to the Republicans.

*Wow then NY is SOL, given the current party leadership.


3 posted on 07/17/2005 10:48:40 PM PDT by cyborg (http://mentalmumblings.blogspot.com/)
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To: cyborg

Paging Hillary, Hillary to the front desk. Health problem in New York which doesn't NEED ANY MORE MONEY.


4 posted on 07/17/2005 10:54:54 PM PDT by taxesareforever (Government is running amuck)
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To: cyborg

The federal Medicare system is much worse.


5 posted on 07/17/2005 10:56:52 PM PDT by TAquinas (Demographics has consequences.)
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To: TAquinas

I am not familiar with that situation enough to comment. I'll take your word for it.


6 posted on 07/17/2005 11:02:29 PM PDT by cyborg (http://mentalmumblings.blogspot.com/)
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To: cyborg; Clemenza; Cacique; NYCVirago; The Mayor; Darksheare; hellinahandcart; Chode; ...

FReepmail me if you want on or off my New York ping list.


7 posted on 07/17/2005 11:05:09 PM PDT by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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To: cyborg

I'm sure that most people in NY are very upset about this.

I'm also sure that they will continue to elect liberals into office.


8 posted on 07/17/2005 11:08:12 PM PDT by Mark (Proven scientific experiment: The NY Times flushes easily down the standard toilet.)
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To: El Gato; JudyB1938; Ernest_at_the_Beach; Robert A. Cook, PE; lepton; LadyDoc; jb6; tiamat; PGalt; ..
FReepmail me if you want on or off my health and science ping list.

Please excuse any redundant pings.

9 posted on 07/17/2005 11:08:15 PM PDT by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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To: cyborg
Unscrupulous doctors and sometimes more then willing patents conspire to cheat the system.

Wherever there is are large concentrations of elderly patients cooked MD's & their billing department cohorts milk both Medicare & Medicaid, through double & even triple billing, coupled with multiplicity of other fraudulent charges. It's all in the codes.

Florida may take the cake, even over New York, since it's basically a gigantic nursing home with medical profession swindlers coming in from everywhere.

10 posted on 07/18/2005 12:38:49 AM PDT by M. Espinola (Freedom is not free)
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To: cyborg

Medicaid and Medicare are likely the most corrupted gubmint programs out there.

They should be grandfathered out with SS.


11 posted on 07/18/2005 12:50:53 AM PDT by k2blader (Was it wrong to kill Terri Shiavo? YES - 83.8%. FR Opinion Poll.)
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To: cyborg

Outstanding post. BTTT! $ocialized Criminals.


12 posted on 07/18/2005 5:27:53 AM PDT by PGalt
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To: PGalt

yup!


13 posted on 07/18/2005 5:28:15 AM PDT by cyborg (http://mentalmumblings.blogspot.com/)
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To: M. Espinola
The question is, how much does the fraud in this program (and by extension, other bloated programs like it) contribute to those EEEVILLL deficits we keep hearing about?

Sigh. And one of the problems is, most of the individual fraud is in such small increments, it costs more to investigate and close a single case, than the amount the fraud was worth in the first place.

14 posted on 07/18/2005 5:34:24 AM PDT by grey_whiskers (The opinions are solely those of the author and are subject to change without notice.)
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Comment #15 Removed by Moderator

To: cyborg; Liz; neverdem; Robert A. Cook, PE; birdsman; Victoria Delsoul; nicmarlo; deadhead; ...

I just heard on the news that a Buffalo administrator enrolled 4,400 student in speech therapy in one day..

A dentist billed for 991 procedures in one day..

Yup, just what we need in this frikin state, more fraud, corruption and abuse.

Just one more reason I am running and created http://www.primarychallenge.org with Lenny Roberto.

We have to find candidates this year to focus on Albany next year.
The only way to beat these corrupt incumbents is in the primary.
Best case would have someone to primary every senator and assemblyman in every district.

Anyone want to help do this? we have coordinators in 22 counties. We need more and need to start now.
http://www.RusThompson.com


16 posted on 07/18/2005 6:09:35 AM PDT by The Mayor ( Pray as if everything depends on God; work as if everything depends on you.)
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To: cyborg
One of the problems is the lawsuits. People sue so much, that doctors have to pay ridiculous amounts to insurance. Which makes patients pay more.
17 posted on 07/18/2005 6:14:49 AM PDT by LauraleeBraswell (I will never again read another thing by Christopher Hitchens !)
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To: cyborg

"I am shocked, shocked there is gambling going on in this establishment." - Casablanca


18 posted on 07/18/2005 6:23:17 AM PDT by stocksthatgoup (http://www.busateripens.com)
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To: cyborg

We design these programs to help people but we don't seem to have the brains to understand that too many people will 'help themselves' if we allow it.

These programs might refuse to pay a bill because you left out your middle initial. Is that what we call a fine "Watchdog Program"?


19 posted on 07/18/2005 6:25:48 AM PDT by B4Ranch ( Report every illegal alien that you meet. Call 866-347-2423, Employers use 888-464-4218)
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To: cyborg

I'm 45 years old, grew up in Jersey, had relatives in NYC (none on public assistance). Mom is from the Bronx. We all knew IN THE 70's that this was going on. I'm astounded that anyone else is astounded.


20 posted on 07/18/2005 6:29:54 AM PDT by floozy22
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To: k2blader
Medicaid and Medicare are likely the most corrupted gubmint programs out there.

Yes and HUD ranks right up there with them. HUD is just as rife with fraud, waste and abuse.
21 posted on 07/18/2005 7:00:43 AM PDT by octobersky
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To: The Mayor
It has drawn dentists like Dr. Dolly Rosen, who within 12 months somehow built the state's biggest Medicaid dental practice out of a Brooklyn storefront, where she claimed to have performed as many as 991 procedures a day in 2003. After The New York Times discovered her extraordinary billings through a computer analysis and questioned the state about them, Dr. Rosen and two associates were indicted on charges of stealing more than $1 million from the program.

Now that's convenient----if this lowlife scam artist gets tried---and that's a big IF----one of those corrupt Brooklyn judges will get a nice fat envelope stuffed with cash to fix her case-----that's taxpayer's cash, of course.

22 posted on 07/18/2005 7:58:21 AM PDT by Liz (You may not be interested in politics; doesn't mean politics isn't interested in you. Pericles)
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To: Liz

You are right on Liz!


23 posted on 07/18/2005 8:00:02 AM PDT by The Mayor ( Pray as if everything depends on God; work as if everything depends on you.)
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To: cyborg
State health officials denied in interviews that Medicaid was easily cheated, saying that they were doing an excellent job of overseeing the program.

Uh-huh. Yeah, right. "State" health officials have a vested interest in seeing that the fraud continues.

24 posted on 07/18/2005 8:03:40 AM PDT by Libertarian444
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To: cyborg

This will never end. The state encourages Lawyers to set up trusts for people who would otherwise not qualify for Medicad to shelter their money so the state taxpaayers pay for their healthcare expenses rather than their own bank accounts. Legalized Fraud.


25 posted on 07/18/2005 8:06:22 AM PDT by 1Old Pro
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To: neverdem

Great stuff.


26 posted on 07/18/2005 9:14:51 AM PDT by GOPJ (Phil Donahue "has made the world safe for emotion masquerading as thought."-BOZELL III)
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To: cyborg

The group that I used to work with helped NY State with Medicaid, Medicare and Social-Security fraud investigations. We quit when Clinton severed us from the program. Then he said that "We will start looking into fraud." We were finding much fraud at the time (1994-95?). Most of the fraud is from companies set up by the Mafia.

From my conversations with ex-Army people from the 1920s and 1930s (the people, not the conservations), it seems that the DOD is probably the worst offender. It's been around longer so there's has been more opportunity for corruption.

Follow the money.


27 posted on 07/18/2005 10:12:21 AM PDT by Doctor Stochastic (Vegetabilisch = chaotisch is der Charakter der Modernen. - Friedrich Schlegel)
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To: grey_whiskers
"The question is, how much does the fraud in this program (and by extension, other bloated programs like it) contribute to those EEEVILLL deficits we keep hearing about?"

It's a substantial chunk! The left would rather abandon Afghanistan & Iraq to the hordes of self detonating Islamokillers and some how everything 'will work itself out', while ignoring domestic contributions to the 'deficit'.

"Sigh. And one of the problems is, most of the individual fraud is in such small increments, it costs more to investigate and close a single case, than the amount the fraud was worth in the first place."

The problem is if the crooks believe they can commit insurance fraud without legal ramifications the fraud will only worsen. It's another bureaucratic black hole.

28 posted on 07/18/2005 3:46:13 PM PDT by M. Espinola (Freedom is not free)
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To: cyborg; Liz; OldFriend

The 'Mob,' what Mob? [America's Mob is the NE's "Democrats"]

BUMPping


29 posted on 07/18/2005 4:10:54 PM PDT by Brian Allen (All that is required to ensure the triumph [of evil] is that Good Men do nothing -- Edmund Burke)
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To: Brian Allen

.....Dims are more ruthless, greedy and and dangerous than That Mob..........


30 posted on 07/18/2005 4:20:28 PM PDT by Liz (You may not be interested in politics; doesn't mean politics isn't interested in you. Pericles)
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To: cyborg

New York is probably one of the biggest problems, because they have so many people. But the fraud is everywhere. My favorite :-) story was about a doctor who was billing Medicaid in Wash, DC for years for doing pap smears for residents of nursing homes. Someone finally noticed that two of the nursing homes were for men only. Whoops - Busted.

Medicaid and Medicare are two money-holes.


31 posted on 07/18/2005 4:33:59 PM PDT by speekinout
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To: octobersky

Oh, no doubt. No doubt at'all..


32 posted on 07/19/2005 12:52:43 AM PDT by k2blader (Was it wrong to kill Terri Shiavo? YES - 83.8%. FR Opinion Poll.)
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To: cyborg
School officials around the state have enrolled tens of thousands of low-income students in speech therapy without the required evaluation, garnering more than $1 billion in questionable Medicaid payments for their districts. One Buffalo school official sent 4,434 students into speech therapy in a single day without talking to them or reviewing their records, according to federal investigators.
33 posted on 07/19/2005 1:00:29 AM PDT by kcvl
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To: Lancey Howard
Medicaid has even drawn several criminal rings that duped the program into paying for an expensive muscle-building drug intended for AIDS patients that was then diverted to bodybuilders, at a cost of tens of millions. A single doctor in Brooklyn prescribed $11.5 million worth of the drug, the vast majority of it after the state said it had tightened rules for covering the drug.
34 posted on 07/19/2005 1:02:20 AM PDT by kcvl
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To: taxesareforever
State health officials denied in interviews that Medicaid was easily cheated, saying that they were doing an excellent job of overseeing the program.
35 posted on 07/19/2005 1:03:24 AM PDT by kcvl
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To: cyborg
For Release: IMMEDIATE: July 27, 2001

STATEMENT BY PEF PRESIDENT ROGER E. BENSON CALLING FOR THE RESIGNATION OF DENNIS P. WHALEN, EXECUTIVE DEPUTY COMMISSIONER, NEW YORK STATE DEPARTMENT OF HEALTH

snip

This is in response to a finding by the State Ethics Commission that Whalen had violated the State Ethics Law by repeatedly accepting gifts and meals from two individuals involved in health related ventures and who represented nursing homes with business pending before the Department.

We're appalled that one of the key state officials responsible for regulating the nursing home industry had his hand in the nursing home industry cookie jar.

36 posted on 07/19/2005 1:08:06 AM PDT by kcvl
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To: Doctor Stochastic
Most of the fraud is from companies set up by the Mafia.

In southern California, MediCal fraud is the preferred occupation for a significant number of recently arrived former residents of several eastern european countries. Because we don't properly police the program, it's become a cottage industry for many. Phony store-front medical supply stores and 'community clinics' are commonplace.

The argument is made that each case is so small that investigation costs exceed the loss, but the reality is that each individual busted for a $200 fraudulent bill is an individual who won't pass off a thousand of them is he's not caught.

The level of investigative effort is truly pathetic. A friend who became aware the clinic at which he worked was processing fraudulent claims on his MediCal number quit the clinic, asked MediCal to give him a new number, and advised them that any further charges on the old number would be fraudulent. MediCal proceeded to pay the bogus charges for the next THREE YEARS, then came after HIM for the money. Pretty amazing.

37 posted on 07/19/2005 1:23:10 AM PDT by ArmstedFragg
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To: ArmstedFragg

The Governor, the Attorney General, the Comptroller and every member of the New York State Legislature should be impeached for this robbery of the taxpayers. But they won't be. No one will "suffer" except for the "Barnumites*" who live here.
(* suckers)
Oh, and by the way, Roger Benson would like for you to forget about this problem......


38 posted on 07/19/2005 4:04:44 AM PDT by Shady
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To: kcvl

LOL


39 posted on 07/19/2005 3:13:46 PM PDT by taxesareforever (Government is running amuck)
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To: Liz

<< ..... Dims are more ruthless, greedy and and dangerous than That Mob .......... >>

Precisely my contention!

Those jokers are, by comparison, pussies.


40 posted on 07/19/2005 4:54:13 PM PDT by Brian Allen (All that is required to ensure the triumph [of evil] is that Good Men do nothing -- Edmund Burke)
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