Doctor Accused Making $800k Plus from Health Care Fraud

Washington Examiner ^ | February 21, 2011 | Emily Babay

[Walts Ice Pick]

The federal government is suing a local doctor to recover more than $800,000 it says he was paid after fraudulently billing Medicare and Medicaid.

In a civil complaint filed in U.S. District Court in Greenbelt, the Department of Health and Human Services says it wants to recover $814,315 that Dr. Abdul Fadul allegedly collected from the two programs through fraud.

The complaint, which also names one of his clinics, the Cardio Vascular Center in La Plata, as a defendant, says Fadul billed Medicare and Medicaid for procedures that weren't performed thousands of times between 2004 and 2005.

[Walts Ice Pick]

More Medicare and Medicaid fraud and more evidence that these welfare programs are due for huge cuts. For thousands of years, people did fine without any of these welfare programs.

[WOBBLY BOB]

Annual Medicare Fraud: $60 Billion; Annual Profits of Top Ten Insurance Companies: $8 billion

http://www.freerepublic.com/focus/f-news/2375829/posts

typical.

[Liz]

NY POST---July 2010---EXCERPT A Bay Parkway, Brooklyn medical office used a Soviet-era propaganda poster to silence Russian immigrants about getting kickbacks for letting doctors submit thousands of bogus Medicare claims in their names....... the Russian-language poster prominently hung in the "kickback room" of the medical office where Russian immigrants lined up for illegal payoffs. Also busted were Medicare "mills" elsewhere in Brooklyn, and in Miami, Detroit, Houston and Baton Rouge, La.

By Paul Martinka

Russian poster shushed immigrant partners in Medicare fraud. Insert pic is
a Russian immigrant not too happy about being nailed for allowing doctors to
submit her Medicare account for 3,774 medical services over six years.......
for a fee.

SOURCE: http://www.nypost.com/p/news/local/brooklyn/hushin_russian_in_klyn_med_fraud_dwMigEMJQtPhYzWlvvIGpM

[kindred]

[Annual Medicare Fraud: $60 Billion; Annual Profits of Top Ten Insurance Companies: $8 billion]

The Lord God of Israel and His Son Jesus Christ give, but democrats and liberals take away and are part of the Wicked of the earth whom the Lord Jesus will root out at His coming.

[Walts Ice Pick]

Wow, that’s truly amazing!

[Col Frank Slade]

Dr. Abdul Fadul ?

[snowrip]

I love it.

The government reimburses doctors (in my state) $0.14 for every dollar they charge, but the doctors are the criminals.

In related news... over the weekend I got a call from my newly-minted 65-year-old mother, who has just moved to a different town and is unable to find a doctor at any of the local practices who is taking new Medicare patients. I wonder how that could be, with our new whiz-bang National Socialist Heathcare Law?

[Califreak]

>The government reimburses doctors (in my state) $0.14 for every dollar they charge, but the doctors are the criminals.<

Some doctors charge 25-50 K for minor treatments, like say-cortisone shots and call it surgery. Those are the doctors that are criminals.

[snowrip]

Interesting. I think I’m going to call you out.

Any treatment by any medical professional anywhere is required to have an alphanumeric billing code on their billing correspondence. Any insurer, including the US govt, is going require proof of medical neccessity for any treatment over $5K. Moreover, a “25-30K charge for minor treatments” are going to raise a double red flag when the billing for such treatments comes from a doctor’s office.

I insure doctors. The overwhelming majority of them are on the edge of excluding all Medicare patients because they cannot afford to provide care for them, as any care given to such patients is essentially free. While I’m sure there are some docs who are crooks, it is virtually impossible for any doctor to do what you claim.

Perhaps you could provide some examples of the figures you cite.

[bgill]

Dr. Abdul Fadul. Hmmm, someone better compare his address book to his cancelled checks. Grab his computers and cell phones for evidence, too.

[Iron Munro]

The literal translation of his Arabic name is:

"The Only One Of Millions Who Got Caught"

[PapaBear3625]

I insure doctors. The overwhelming majority of them are on the edge of excluding all Medicare patients because they cannot afford to provide care for them, as any care given to such patients is essentially free. While I’m sure there are some docs who are crooks, it is virtually impossible for any doctor to do what you claim.

Put another way, honest docs cannot afford to deal with the Medicare system and still stay in business, leaving the field to docs with "creative" billing ideas which cost the system far more money than if they had rates that honest docs could live with.

[bgill]

Some doctors charge $400 for a single dose bottle of grape flavored laxative that Walgreens sales for about a dollar.

[djf]

It’s going beyond Medicare and Medicaid refusal.

There is a growing number of doctors who are charging a flat in-the-door rate of like 25 bucks for a visit/exam.

No insurance allowed. None.
Takes way too much time and trouble to handle the insurance end, time and trouble that can be used to focus on patients.

[bgill]

There’s a pediatric doctor here who makes fully insured parents fill out a medicare form before she will give their kids the prescription or shots they need. She knows that worried parents will sign anything to get immediate treatment for their kids. A parent asked for their child’s medical record to be transferred and got a copy of it. The doctor had written up that the parent unfit and was endangering the child’s life, blah, blah, just because she had asked a minor question of the doctor.

[Califreak]

You can call me out all day.

SAYING you insure doctors and implying you have some sort of expertise in the matter is all good and fine, but you didn’t provide any proof of that before you “called me out” did you?

>While I’m sure there are some docs who are crooks, it is virtually impossible for any doctor to do what you claim.<

Some doctors(or whoever is doing their billing)will lie and use different codes to describe what was actually done.

>Moreover, a “25-30K charge for minor treatments” are going to raise a double red flag when the billing for such treatments comes from a doctor’s office.<

Sure-it should raise a red flag. Sometimes these things have to be pointed out to the insurance company and the state medical board.

>Perhaps you could provide some examples of the figures you cite.<

Unfortunately, I can’t really divulge any more details and expect to retain anonymity.

Why do you need this information so desperately?

[goodnesswins]

I’ve been going to a doctor like that for several years...gives us more control over HEALTH also. (but, I don’t pay $25 (more like $300/hr) - cause I only see the doc once a year for blood work, etc.) (Worth EVERY PENNY!)

[ketelone]

Allah-lalalalalalalalalah!

[Califreak]

I thought that was a hospital thing.

I’ve heard that some people who are on maintenance meds can bring their meds to the hospital to avoid the outrageous charges for each pill. I tried to do something like that when hubs was in the hospital but they refused.

I can’t really blame them though. I expect they wouldn’t want any more liability issues then they already have. I was discussing crooked docs earlier, but there are also crooked patients who probably make a living out of suing people and never leave the house without a banana peel to trip on somewhere.

[djf]

I would bet 90% of Doctor visits are for (relatively) minor issues.

Somebody cut themselves and needs a couple stitches. Kids with ear infections. Somebody stepped on a nail and needs a tetanus shot. Prescription refills.

If I were a doctor I would have 3 rules:
No insurance
You must sign and agree to a promise you WILL NOT SUE FOR MALPRACTICE
IF I was to find something serious and recommended you go to a specialist, YOU MUST GO, or I will cease treating you.