Friday, February 18, 2011

Medicare Scammers Busted

I am always happy when I read about fraudulent doctors, nurses and businessmen getting busted.  Medicare is, unfortunately, a program that lends itself to crooks.  The more of these crooks that get prosecuted and sent to jail, the happier I am.  Each of these busts should be made public.  This time Federal authorities have charged over 100 doctors, nurses and physical therapists with massive Medicare fraud in Miami, Los Angeles, Dallas, Houston, Detroit, Chicago, Brooklyn, Tampa and Baton Rouge.

These crooks billed Medicare more than $225 million for services that were not performed.  One Brooklyn proctologist billed $6.5 million for phony hemorrhoid removals.  He claimed he performed 10 on one patient alone.  Impossible!   Are there even that many potential hemorrhoids in Brooklyn?  A podiatrist billed Medicare $700,000 for toenail removals.  The stupid guy said he removed 20 nails on 3 toes of one patient.

Three physical therapy clinics that were run by an organized network of Russian immigrants billed $57 million for elderly patients that had no PT.   This involved the usual recruitment and kickback to elderly patients just to get their Medicare number.

Medicare is one of the largest health care payers in the world with 1.3 million licensed suppliers nationwide.  Medicare not only pays doctors and hospitals, but also chiropractors, podiatrists, physical therapists, Christian Science practitioners,  home health agencies, medical supplies and  equipment manufacturers.

Now that Medicare is so large and cumbersome, we need to strengthen the enforcement and applications for providers.  How about criminal background checks for provider applicants?  Unfortunately, right now  a fraudulent clinic can shut down in one locale and open a new operation and begin billing all over again. 

As a taxpayer I support strict enforcement and prosecution.  As a primary care physician who saw her reimbursement cut this year to $84.00 for taking care of a complicated medicare patient, I am outraged at the waste.

20 comments:

KM said...

Why is Medicare paying" Christian Science practitioners"? Are any of them a licensed medical professional as well a being part of that religion?

gradydoctor said...

Just catching up with the posts! Great stuff--I agree that the scanners make it hard on us all!

BTW--you were my blog winner. The last few days underscores it--you're on fire!

gradydoctor said...

Whoops "scammers"-- don't you just love autocorrect?

Felcy said...

Really well done for the blog.these are so sweet and pretty!

Good Health

Michael Kirsch, M.D. said...

You are on point,as usual. Fraud is an outrage, but it is unneccessary medical care that is bleeding the system. While I also support vigorous enforcement, this is not where most of the wasted money is.

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