Medicare Fraud

Every year, we lose billions of dollars to fraud in federal and state health care programs. Every dollar we lose to fraud and abuse is a dollar that is not available to provide home care to seniors, to treat HIV and AIDS, to immunize children, and to discover new treatments for cancer and other diseases. Some fraud schemes even pose a direct threat to the health and safety of patients. Many instances of health care fraud sug­gest that existing control systems do not work the way we imagine they should. Often the manner in which schemes are revealed suggests detection is more luck than system. Whistleblower lawsuits have exposed billing by health care providers for services not rendered, billing for products not delivered, misrepresenting services, unbundling services, billing for medically unnecessary services, duplicate billing, increasing units of service which are subject to a payment rate, falsifying cost reports resulting in increased payment to the health care provider, kickbacks, and on and on. Healthcare fraud is still going strong and this blog is intended to keep readers up to date with all healthcare fraud related news and to provide commentary when warranted. This blog also contains an array of laws and regulations concerning healthcare fraud set out in an easy to read format.

Physicians Snared By Growing Medicare Fraud Strike Team

by admin on July 15, 2009

Marcella Auerbach was quoted by Amy Lynn Sorrel in her article “Physicians snared by growing Medicare fraud strike team,” which appeared in the July 6 online edition of American Medical News. The article discussed the announcement by the Department of Justice and Health & Human Services that criminal charges were filed against 53 doctors and healthcare professionals for allegedly scheming to submit false Medicare claims in the Detroit area.

These indictments come immediately after the government recently publicized the creation of a Medicare anti-fraud task force aimed at reducing the millions of dollars wasted every year in healthcare fraud. The task force has said it will focus on all participants in fraud, be it the corporation, the physician, or even patients.  

Marcella pointed out that she believed there will be many more similar Medicare fraud indictments and cases in the near future. Meanwhile, whistleblowers will continue to play an important and crucial role in the government’s crackdown on healthcare fraud. When employees or physicians who are aware of misconduct do not come forward, the government will initiate investigations proactively, often resulting in a large number of indictments against the company or hospital, as demonstrated by this bellwether case in Detroit.

Share and Enjoy:
  • Digg
  • Sphinn
  • del.icio.us
  • Facebook
  • Mixx
  • Google
  • Fark
  • Propeller
  • SphereIt
  • StumbleUpon
  • TwitThis

Leave a Comment