Posted on 02/22/2011 8:05:42 AM PST by 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.
(Excerpt) Read more at washingtonexaminer.com ...
True, the “creative billing” docs cost the system more per doctor, but are only a part of the problem. The Medicare system is losing money because of its own infrastructure, and because so much of the funding which should be allotted to it is being siphoned off for other govt overspending (with those sweet US Government IOUs left in place of real funding). The govt cannot afford to pay doctors and hospitals better rates because they have already spent the money elsewhere on things that are not claims-related.
Honest docs cannot afford to stay in business with current reimbursement rates. I know several hundred small-practice MDs and specialists, and it is a purely stop-loss business decision: cut the Medicare patients down to the smallest number possible, or go out of business.
>Honest docs cannot afford to stay in business with current reimbursement rates. I know several hundred small-practice MDs and specialists, and it is a purely stop-loss business decision: cut the Medicare patients down to the smallest number possible, or go out of business.<
That’s a real shame.
Billing and rates are so strange. When my husband was in the hospital, the cancer doc that came in and shook his hand billed more for that than the surgeon who opened up his lungs and probably saved his life so he could pursue his treatment did.
But the cancer doc is probably continuously upgrading his education and knowledge due to new innovations in treatment.
If you were really charged more for what insurers call a “Physician’s Visit While Hospital Confined” than for a surgical procedure, you should probably have your insurer look into the bill for overcharges.
Of course, if it were a bill for a visit from the Chief of Oncology versus the personal bill from a regular surgeon, that I can see (providing it was a long visit, a simple surgery, and the discrepancy was a small one). Your surgeon may have also forgone a part of his bill for services due to insurance policy restrictions or another arrangement with the insurer or the hospital.
She should be reported——big red flag for govt healthcare fraud.
>If you were really charged more for what insurers call a Physicians Visit While Hospital Confined than for a surgical procedure, you should probably have your insurer look into the bill for overcharges.<
He is the chief of oncology and all of the doctors who cared and continue to care for my husband have been phenomenal.
Thankfully, my husband is doing extremely well now.
>Your surgeon may have also forgone a part of his bill for services due to insurance policy restrictions or another arrangement with the insurer or the hospital.<
Maybe so. She is an excellent surgeon and has pioneered several new laser procedures.
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