Home health care fraud was included in indictments of 111 defendants today for Medicare and Medicaid fraud, filed by Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius. The investigations carried out by the Medicare Fraud Strike Force that are targeting Medicare and Medicaid fraud.
Medicare programs amount to more than $500 billion and because of ineffective monitor systems of providers, fraudsters have been attracted to becoming providers. The Wall Street Journal has filed suit for access to records of payments made to medical doctors via Medicare to assist with holding accountability. The American Medical Association previously won a suit against the government in 1979 to keep records private. It is believed by some that by having access to this information, nonprofit organizations, newspapers, state medical boards and others with interests in fairness and legal management of government programs would hold providers accountable.
One of the defendants is a medical doctor in Dallas who was receiving kick-backs for home health care referrals by seniors who did not need the home health care.
Apparently one doctor in Detroit can’t count either – he billed Medicare for removing 18 toenails on one senior – but a the same time, with technology allowing for efficiencies, it is too bad Medicare doesn’t have better systems in place to stop a payment like this from happening in the first place. Another doctor billed for 85 hemorrhoid removals on one patient.
Secretary of Health and Human Services Sebelius agrees that Medicare needs to have better reporting systems to catch fraud before it happens and says O’bama’s new health care plan does include better systems.
The Wall Street Journal has been pushing for better systems, too, and mined a database to discover the top billers were some of the top fraudsters.
Learn more about the cost of senior care, including nursing home prices nationwide.
