 |
|
Posted by
Dan Conston
on
July 17, 2009
The Ways and Means Committee tonight failed to pass an amendment offered by Congressman Peter Roskam (R-IL) that would have substantially combated waste, fraud and abuse in Medicare, Medicaid, CHIP and the proposed government-run health plan. The amendment would have required creating a system of real-time data review, like the credit card industry employs, to prevent fraud and abuse at the point of sale, before money is paid out. “This common-sense amendment would’ve meaningfully reformed Medicare and Medicaid’s rampant waste, fraud and abuse – which is necessary to reform healthcare and save the hardworking American taxpayer precious money,” said Congressman Peter Roskam. “It’s extremely disappointing, though not altogether surprising, that Democrats have blocked another... Read the full post
Posted by
Dan Conston
on
July 17, 2009
The Philadelphia Inquirer reported today about a New Jersey dentist who pleaded guilty to defrauding the New Jersey Medicaid program of hundreds of thousands of dollars. Joshua Prensky was supposed to be providing mobile dental services to elderly patients residing in assisted living facilities. He instead improperly billed Medicaid for procedures that never occurred. Prensky faces up to five years in prison and $84,000 in restitution, much less than the amount he stole from the Medicaid system. Read the whole story... Read the full post
Posted by
Dan Conston
on
July 16, 2009
Today, the New York Times reported that six people in New York were charged with stealing over $47million from Medicaid over the last 10 years. The man accused of leading the fraud and money-laundering scheme, Alexander Levy, had previously been part of a Medicaid fraud case and thus was barred from providing services - butthe fraud was still able to go on using associates close to him and in his companies. He owned a home healthcare agency, two ambulette companies and three medical clinics. “On the day we are debating the future of healthcare in America, the staggering amounts of waste, fraud and abuse in our current government run healthcare system should give great pause to those in Congress pushing for a new, larger government run healthcare system,” said Congressman Peter Roskam.... Read the full post
Posted by
Dan Conston
on
July 15, 2009
The Wichita Business Journal reports that yesterday a Wichita woman was sentenced to two years in prison for defrauding Medicaid. Shelly Harding, who operated a community-based alcohol and drug abuse treatment facility, pleaded guilty in April to submitting fraudulent claims to Medicaid for drug and alcohol treatment services that were never provided from 2001-2006. These fraudulent claims included drug and alcohol treatment provided to approximately 81 children under the age of 12. Read the full story... Read the full post
Posted by
Dan Conston
on
July 14, 2009
Today, the Associated Press and Star-Ledger are reporting that New Jersey prosecutors have charged a local surgeon with defrauding Medicare, Medicaid and other insurers of more than $8.5 million, including $4.7 million from Medicare alone. Dr. Khashayar Salartash and his office manager stand accused of submitting fraudulent claims for nearly five years including billing for surgery when only physical therapy was required. Read more about this latest fraud here and here.... Read the full post
Posted by
Dan Conston
on
July 13, 2009
Over the weekend, the Houston Chronicle reported the latest instance of massive Medicare fraud where funds had been shipped out of the U.S. In a probable cause hearing Tuesday, Nigerian citizen Umawa Oke Imo was accused of operating a multimillion dollar health care scheme – and authorities believe he sent a great portion of those funds back to Nigeria. Authorities say that Imo’s City Nursing Services of Texas was paid $30 million in Medicare claims for therapy services from 2007-2009, without ever having a single licensed physical therapist on staff. During that time, Imo is rumored to have spent $2.8 million on equipment which was shipped to Nigeria, as well as on purchasing a 25-room house in Nigeria. In response to this trial, a Houston FBI spokeswoman said, “The theft of... Read the full post
Posted by
Dan Conston
on
July 10, 2009
Yesterday, multiple news sources including the Los Angeles Times, New York Times and CNN reported on the largest Medicaid fraud case in the history of California.Untrained nurses received millions in reimbursements from the state to care for seventy-five children and adults with disabilities. Authorities arrested twenty of the forty-two accused, charging them with conspiracy to commit health care fraud. One of the leaders of the fraud ring, Susan Bendingo, fled the country after being charged and is presumed to be hiding in the Philippines. “We believe that this is the largest single case alleging Medi-Cal fraud ever filed in the state ofCalifornia,” said United States Atty. Thomas O’Brien. “Medicare and Medicaid fraud are not victimless crimes," said Congressman Peter Roskam.... Read the full post
Posted by
Dan Conston
on
July 09, 2009
Last week, ABC News’ “20/20” Co-Anchor John Stossel wrote a commentary piece about some of the inherent fraud and management issues confronting Medicare’s current system. Stossel aptly points out that while Medicare’s low administrative costs are touted as a positive, there would be far less fraud and abuse if there were more administrative dollars devoted to preventing fraud (emphasis added): "But last month on "20/20" producer Miguel Sancho and I reported on Medicare’s $34 trillion in unfunded liabilities, on how Medicare is a prime example of government promising MUCH more -- that it is prepared to deliver. But the Obama administration has succeeded in promoting the fiction that Medicare is a shining example of government working well. Statists suggests that because Medicare only... Read the full post
Posted by
Dan Conston
on
July 08, 2009
Last night, the Miami Herald reported that Jose Luis Perez, who along with his partner made $56 million by submitting fraudulent Medicare claims, has fled the country before agents could arrest him. Described by the FBI as an “international traveler,” Mr. Perez is counted among 60 suspects charged with Medicare fraud that have fled the United States over the last five years, “after scamming hundreds of millions of dollars.” The story also states that in a related Medicare fraud scheme last month, which I commented on here, a different Miami man charged in a $100 million Medicare scheme across five states had fled and is still a fugitive. “This massive defrauding of the American taxpayer is a solemn reminder of just how much money is lost and never recovered from Medicare waste, fraud... Read the full post
Posted by
Dan Conston
on
July 07, 2009
Yesterday, a physician assistant in Los Angeles was convicted for his part in a $7.7 million Medicare fraud scheme. The convict, Ronald Bradshaw, used the physician identification number of a local unwitting doctor to forge hundreds of medically unnecessary prescriptions for motorized wheelchairs and custom-fitted orthotics. In total, Mr. Bradshaw billed Medicare just over $7.7 million under the doctor’s name. “This latest case of fraud is a textbook example of just how severe the problems facing Medicare’s antiquated operating systems are,” said Congressman Peter Roskam. “Without meaningfully reforming the operating practices Medicare currently employs, a new government-run health insurance plan will be fraught with even greater waste, fraud and abuse.” Read more about this latest... Read the full post
|