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Medicare fraud: outrageous

Posted: Monday, December 10, 2007 11:50 AM by Barbara Raab

By Mark Potter, NBC News correspondent

If you've been around long enough, you find yourself bragging that "nothing shocks me any more." I say that a lot, and often it's true. But then I started looking into Medicare fraud, and was I shocked! Floored, actually. Medicare fraud is an outrageous pilferage of your and my money--an estimated $60 billion dollar-a-year theft. Until I looked closer, I had no idea just how widespread it is, and how brazenly an army of criminals has turned America's social safety net for 43 million seniors and the disabled into its personal bank account.

In reporting this week's two-part series on Medicare fraud for Nightly News (watch a preview here), I rode with a private investigator, and later went with some FBI agents as they checked on storefront operations that purport to be legitimate medical supply companies. In most cases, they are actually just "fronts" or shell-companies designed only to bilk Medicare. They have nothing to do with actual health care.

In one building alone, I saw nearly 30 offices with signs saying they were either medical supply companies or medical billing companies. Most of the doors, however, were locked, with no indications anywhere of legitimate business. I saw the same thing in other buildings, and in shopping centers--row after row of supposed medical companies that, according to federal authorities, are billing Medicare for millions of dollars each, for services never rendered, for patients never served. The main function of these offices is to fool Medicare inspectors, who rarely visit.

In the next two evenings on our air you'll see some shocking things: a multi-million dollar wheelchair (at least that's how it was billed) and patients being paid cash to cooperate in a fraud scheme.

You'll also meet some interesting people, including Miami's retired Chief Federal Judge Edward Davis, who learned that criminals had stolen his patient ID number and billed Medicare for something that he described as "outrageous"--that same word again. We'll show you what it was. And you'll also hear from a one-time Medicare thief who stole millions and now says it was way too easy.

A while back, Michael Leavitt, the U.S. Secretary for Housing and Human Services, was taken on the same fraud tour in the Miami area that I took. And his reaction was exactly the same. When he got home that night, he told his wife, "In a decade and a half of public service this was the most disheartening, disgusting day I have ever spent. We have to fix this!"

There are a lot of ideas on how to do that, and we'll share some of those thoughts, too. Perhaps 82-year-old Muriel Sherman, whose Medicare patient number was stolen and abused for years, has the best rallying cry: "For these people to do this and not be apprehended is an absolute insult to me, and everyone else." Fix it, indeed.

Editor's Note: Mark Potter's report airs tonight on the broadcast.

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Comments

  I'm on medicare and find this so sick,medicare should set up id numbers to companys who provide services and the company owner should have a crimial and other back ground check.Then the store should be checked out before they can open for business.Anyone who defrauds medicare should be looking at a long time in prison.The government can find ways to stop alot of these fake companys from opening in the frist place and every month they have to send records to a check system.To make sure the company is real. Before medicare pays for for supplys,they can check supply company id's,which has had crimnial back ground checks and finance record of the owners and companys.This has to stop now.
I think they better look at the health clinics also, you get a flu shot for $12.00 and they also charge medicare $17.00 for giving it to ya, and the whole thing took about a minute.
also I would like to know how they pay, I have Arthritis and get foot infections a lot and the Doctor wrote a precription for special insoles, medicare will not pay for them unless you have diabetis, how can the goverment discrimate and nobody else can do it.
Anyone on Medicare understands how easy it would be for thieves to use their medicare number and they would not even know about it.  I am a college-educated person, intelligent, on top of things, but after 9 years, not once have I have been able to figure out my husband's medicare statements.
Having been a Medicare "Provider" since its inception in 1966, I can tell you that nothing changes for the better. "Provider Numbers" were supposed to prevent fraud.  Now NPI numbers are supposed to prevent fraud, they won't! CMS has neither the talent, desire nor intesinal fortitude to make their contractors take responsibility for their gross incopetance.  CMS CANNOT IDENTIFY WHO IS OR IS NOT AN AMPUTEE!  When a CMS contractor screws up, they (the contractors) pour on the regulations TO THE PROVIDERS, with CMS blessings!  One simple question: Why does my government trust me to pay my rent & buy my food yet does not trust me to buy my healthcare? If I'm trustworthy enough to spend my Social Security check wisely, then why can't I be trusted to purchase my own healthcare using the money that I've paid in, just like my social security?  
    Yes, individuals can also be taken advantage of but, the numbers are in our favor not the thieves!  As it is now the thieves only have to take advantage of one entity, using multiple individual's names and I.D. numbers.  It would be next to impossible to take advantage of thousands of individuals buying their own healthcare.
  Also, CMS has such an assortment of laws, local policies and directives that many are in direct conflict of one another as well as Federal Law. One such example is that I MUST have an original signiture on file for any item that I deliver (apply or fit) to a Medicare patient.  YET, it perfectly legal for me to put the same item in a box and ship it to the patient, providing that he/she signs for the item.  Have you EVER seen an "ORIGINAL" signiture provided by UPS or FEDEX?  CMS needs to get its own house in order, instead of dumping on me and other providers in the name of stopping fraud.  Yes, the fraud needs to be stopped, but CMS hasn't look for the answer, only the scapegoat!
My thoughts go back to the Founding Fathers who knew that in order to have total freedom, a moral compass would be required of each citizen.

Many people have no conscience, and feel that if they don't get caught, it must be alright to cheat.

What is not mentioned in the article is that MANY of the "cheaters" are newly arrived immigrants.  
I checked my hospital bill for a 5 hour trip to the ER, it went to medicare and they paid the 80%, but I was billed for $2,285.00.  I protested this and asked for an itemized bill to be sent to me. There were many things listed on there that I did not receive, a MRI, a TVUS, an eltrocardiagram reading, lots of blood work and many drugs. I went to the ER for low blood sugar. They did a blood sugar on me took my BP gave me an IV of 5% dextrose and sent me home. They blamed it on the office transcriber. I followed through on this and asked that medicare be reimbursed for the over payment and that this be taken off of my record. I received a nice letter from BC thanking me for following through. My entire cost was brought down to $78.00 It took 9 months to settle this. I also had to get this removed from my credit report as the hospital turned me in for non payment. Always check your billings from any clinic or hospital regardless of insurance holder.
Mike Leavitt certainly shouldn't be surprised by the cases of Medicare fraud. He must know of Jeb Bush's (the president's brother) involvement in the largest case of Medicare fraud. Ask anyone in the Miami area and they will relate the story of one Recarey and his relationship with Jeb Bush. Recarey fled the USA to avoid prosecution.  A five minute web search will reveal the whole story.  
When our bitterness at the waste becomes so great then we will become active in our government again; until such time that we the citizens become involved and report the abuse then it will stop.
We have medicare in Australia and as far as I know, fraud is not an issue.
Come on down, take a look, study, in your language, and then imitate!
Just think of all the fraud the tax payers will have to pay for if the Democrats get their wish of Universal Health Care.  The government is sure doing a great job with Medicare....  What a joke!
Greed is both the greatest scurge to our financial industries and its greatest benefactor.  Remember that the same kind of greed that drives these fraudsters to rip off the American people also drove the founders of all -- EVERY ONE -- of America's corporations.   Yes, we need to get better government accounting, and, yes, we need to catch and prosecute these criminals, but greed is one of the most powerful and pervasive of American traits.  Fraud will not be stopped until it can be made un-lucrative.  So, too, with drugs, pornography, and, yes, legitimate business as well.
What a surprise! government run program and fraud. when will we get it. bureaucrats and government employees do not care.  it is only taxpayer monies. the free market is the only way to limit fraud...including health care.  
If you want to see a huge opportunity for fraud, check out equipment for sleep apnea, CPAP masks in particular.  Medical equipment companies double or triple the original price and then sell some aspects of the masks as if they are separate equipment. They will sell the cushion of the mask as if it is a separate piece. You can't buy this cushion separately from the people that make the masks. This is like going into Walmart to buy your child a turtle and being changed $3.00 for the turtle (that originally cost Wal Mart $1.00) and $2.00 more for the shell. When you consider the numbers of people being treated for sleep apnea, the profits these practices bring to these companies is staggering.
As an owner of a small medical equipment company in Miami that provides Medical Equipment, Orthotics and Mastectomy Products for the last 14 years, have been accredited for the last 10 years and I sit on the Board of the Florida Association of Medical Equipment Dearlers for the last 12 years,  I will like to request that you include in your program a section on legitimate providers in South Florida.  There are many companies that are providing excellent services but because they are in South Florida they are all targeted at the same time.  Payments are being denied by Medicare stating that services were not provided and they were.  In order to get pay the company has to send a copy of all documentation in patients file and this will take approximately 3 to 6 months.  If payment is denied again the company will need to request a Hearing with an Administrative Law Judge and this could take up to a year or more. All of this could be prevented if Medicare just call the patient and check if they receive the services.  
Why have we spent millions of dollars worrying about physicians working in the trenches and actually taking care of medicare clients.  We spend countless hours reviewing our charting to make sure that we are "coding" correctly so that we can get paid 35 cents on the dollar and then worry that we may have put down the wrong code.  Maybe we are barking up the wrong tree.  Let's actually stop some real fraud and take the money that we save and pay physicians a fair price for their services.  
Maybe if our government officials (meaning especially the House and the Senate) weren't so busy stabbing each other in the back and trying to squirrel money away for their pet projects we could afford to put enough people in place to oversee these programs and reduce or eliminate the fraud.

Maybe I'll write my Congressman.  Naw! Forget it.  I'll just get a canned email back thanking me for my support and telling me about the hundred thousand dollars we're going to spend to put up a statue in some town I never heard of in West Virginia in honor of Robert Byrd.  What a country!
If you think it is bad in Florida and Houston, you should check Mississippi!  I hate for people to say Mississippi is the poorest state in the nation.  Truth be told, we are sinking most of our federal and state dollars into supporting people who actively commit Medicaid and Medicare Fraud. When you call to turn these people in, the people at the state office simply don't give a damn.  In Mississippi, it is more of the patients committing fraud than companies. They doctor shop.  They get prescriptions filled that they flush down the toilet.  Some of them pretend to be "crazy" to get a disability check.  Others make their children pretend "craziness" for about $500/month.  Seeing as how Mississippi is a mostly Republican state, you would think our lawmakers and representatives would care more. They don't give a damn, either. They never even address the fact that in Mississippi, you have whole generations of children, Black and white, being raised with this kind of fraud, while people who are in their 80s and 90s can barely get enough help to buy groceries.  I feel sorry for college students and Mississippi seniors.  When it comes to them, the state never has enough money. When it comes to people just plain being lazy, sitting on their behinds faking injuries, and having baby after baby, there's always plenty to go around while the rest of us citizens scratch our heads just to make ends meet.
I work for a major pharmacy and work in the medicare billing dept.  I see my company billing medicare in error all the time.  This has been a huge problem with the company.  CMS has been informed about this and did nothing.  I know the company has received thousands and thousands of dollars that should be paid back to medicare but never is.
We are a nation of smart people, we should be able to get a group of people to together and develop a punishment the will be an effective deterrent.  Here are some suggestions.  Punishments should be dished out to all involved -  the Medicare care agency workers for being asleep at the wheel(demotion but reward them for stopping fraud by giving them a bonus base on a % of the $ saved), the patient who turn a blind eye to fraud (reduced benefits but again give them a inventive to report fraud - say 10-50K for every successful prosecution) and for the perpitrator (bullet to the back of the head like the poor Chinese sap for taking @800K in bribery is a bit much to ask) - but it's worth a shot.    
Well down in the wild, wild, WEST, Texas, medicare ran me out of business for doing home visits and saving them thousands of dollars. I guess being a black doctor makes the difference in getting catch. After FBI, OIG, State Board of Medical Examiners and a 6 year administrative marathon, am still trying to get my name back. All doctors are not out to robe Medicare.
The "durable medical equipment Medicare benefit accounts for less than 2 cents of each Medicare dollar spent. The same degree of fraud and abuse exist in Hospitals, Physician practices, Labratories and any sector of healthcare but the numbers are much higher. Yet again and again the media reports on this small segment. Where's the balance in reporting to the people the entire story of the mess in our great country's healthcare system? Is there a political agenda that news media has an interest in that makes it desirable to concentrate it's efforts on this small but efficient and effective component (minus the few ripoff artists that take advantage of the system our government set up) of our national healthcare system?
Like Crime, fraud is where you look for it. You will probably find fraud in any industry you choose to turn your camera's on. I attended a meeting last year where thoe OIG admitted it saves the government more money that the government spends to run the OIG. I say let the Government take the savings and spend it on enlarging the OIG.    
IT DOES SEEM THAT WE ARE SINGLED OUT ...STILL MANY BILLIONS LOST ARE ALSO ATTRIBUTED TO THE HEALTH PROFESSION IN GENERAL ...DOCTORS NURSES AND HOSPITALS WHO IN SOME CASES BILL MANY MILLIONS MORE FOR FRAUDULENT SERVICES THAN WE EVER COULD ..WHY IS THIS NOT BEING SINGLED OUT ...WE ARE ONLY A FRACTION OF MEDICARE SPENDING ...REPORT IT FAIRLY...DOUBTFUL .......IS THE FBI ONLY TAKING THE REPORTER TO KNOWN FRONTS ..OR IS HE GETTING HIS FAIR SHARE OF LEGITIMATE BUISNESS INTERVIEWS ...IF HE COMES AND SEE.S ME I CAN TAKE HIM TO 1 BUILDING THAT HAD 40 FRONTS ..OR I COULD ALSO TAKE HIM TO 100 LEGITIMATE SUPPLIERS IN THIS BUISNESS ...HOW OBJECTIVE IS HE WILLING TO BE ...???
I have been in this industry for 17 years and have worked with many other HME companies that are not only above the reports that you have provided but offer superior service to our aging.  The area you are reporting on is old news.  Why don't you report on companies that are doing good things for the HME industry, that belong to state and national associations, and are accredited to abide by the suplier standards.  I can name many thoughout Michigan and the midwest who do just that.  If the government gave out supplier numbers without thorough investigation of their business practices, then they should be held accountable.  Not the rest of the industry who are the good guys.
The loonies on the left continue to believe that Medicare and other government fraud are the fault of the Bush Administration alone as if these were new phenonema. News for the loonies: people have been scamming the US, state and local governments since day one back in 1789. The reason, government workers! They have zero incentive to do a good job and of course in 2007 zero accountability when they do a bad job. No one ever gets fired in government La la land except for murder, rape and pillage. Medicare scams will continue as long as we allow our money to be administered by government employees. We need to privatize and incentivize Medicare watchdogs to nail the bad guys. If you want to catch rabbits you use grayhounds not drayhorses.
Be very careful not to blame the true Medicare providers for Medicare's blatant disregard in making it easy for thieves to steal taxpayers money.

Wasn't there a famous criminal that said he stole money from banks because, "that's where the money is."  Obviously, these criminals know where the money is...
Pay investigators 1% of the frauds that they uncover. This is the cheapest way to clean this up and keep it cleaned up! Send the bills directly to these investigators before Medicare pays the bill.
Private insurance companies, not for profit only, should receive a set number of dollars to care for each Medicare beneficiary.  The Federal government should no longer try to be an insurance company, it doesn't work.  I am a RN specializing in Medicare who is ethical and careful with the taxpayers money while at the same time ensuring proper access to Medicare benefits to enrolees. However, there are MANY gray areas in healthcare and shifting the care to local insurers would work much better.
"..just imagine the thievery that will occur if a national healthcare program is implemented...."

That's ridiculous and nothing but typical government hating right wing rhetoric and fearmongering.  It's the same baseless and ignorant mentality that keeps us from importing safe drugs from Canada.  Self serving simpleton garbage, nothing more, nothing less.

Medical fraud can be fought effectively with the right resources and people.  It's all a matter of priority.
How about severe penalties, including death for defauding the taxpayers. They can't be treated like white collar criminals anymore.  
I have been involved in the medical equipment industry for 30 years and have seen fraud escalate because CMS has allowed it to happen.

Simple steps have not been implemented to prevent fraud from occurring.  

For example:

• A new provider with an immediate client base should throw up red flags.

• A physician's ID number used multiple times for like equipment during a month should be investigated.  

• A diagnosis used with beneficiary numbers under Part B which does not coincide with diagnoses registered under Part A and where no physician visits or hospitalizations are billed and yet medical equipment is being prescribed are triggers that something is amiss.

• A medical equipment serial number detected if used more than once could be easily spotted.  

I could go on and on.  

Someone needs to be held responsible for maintaining an agency without seemingly simple mechanisms in this day and age that would help curtail this abuse.

In the meantime our company stopped serving new Medicare clients because Medicare would not pay for the complex rehab equipment we provide.  People are being denied access to the reputable equipment providers because CMS has not done it's job of protecting those dollars paid in by the American people.

Upper management at CMS needs to be held accountable now!






I own a company that should be collecting Medicare dollars but am unable due to the fact that the Nursing homes in my area collect the monies then refuse to reimburse the contractors. They make the patients pay the bill .. now thats fraud! I have complained to Medicare and AHCA, it does no good, they look the other way. Facilities in my area are stealing on average about $4,000,000/yr. Since we have 9 local facilities and they ALL do it, thats $36,000,000/yr. AHCA doesn't care! They know it, its been reported by the patients as well. Homecare agencies in this area are another huge defrauder of Medicare, ACHA looks the other way for them too! I see it EVERY day.
Medicare has created a large and very expensive arm of the government. They continue to add staff and programs while not doing their core mission.  If CMS had been doing their job from the start and policing it's self as well as provider industries, fraud would be almost nonexistent. Instead very little has been done over the years.  Now as we face a silver wave that will engulf all health care services, CMS is frantic to cut costs. Fraud now is the least of their problems.  When people go into nursing homes because they lack the availability of home medical equipment and those connected services, the taxpayers will be paying a much, much larger bill. Right now politics is   fueling this attention and while I agree that all fraud should be examined and eliminated, we must be very careful about not cutting so deeply that we all bleed.    
While Medicare is being ripped off with fraudulant claims for equipment, every Senior Citizen on Social Security, is also being ripped off by the increasing Medicare monthly premiums.
In the 6 years I have been retired, collecting just Social Security, the monthly deduction for Medicare premiums taken from my check, has increased more than 112%. Plus, I pay a monthly premium for supplimental insurance as well, which has also increased over the years. Bringing my total monthly cost for Medical coverage, so far, to more than $140.00 per month. Each.(myself and my wife) This is out of our only income. Social Security.
How's that for trying to cope with overall increasing costs?
Owner's of the business out of the country? If the inspections are carried out properly before issuing a Medicare number  and things look fishy why aren't the inspectors returning. $500,000.00 a month in sales for a new business. Does that send up any red flags? does the paperwork show the same Doctors name on every prescrition? Sounds like another red flag. did anyone check the serial number being billed? Did anyone call the manufacturer and see if the company bought any wheelchairs last month? They would have had to if they billed $500,000.00.The fraud department needs some advice from the legitimate suppliers in the industry. The government gets bilked, the criminals leave the country, or get put in jail, very little money is recovered, the guys who follow the rules clean up the mess.The story never really changes.
Jackie Rawlings, you are worried about what Bush and the GOP are doing and they dont talk to you, but Hilary and the Democrats are doing a lot about it now arent they?  They have had control of the House and Senate for over a year and have accomplished nothing.  Who are you going to blame if they ever get total control and you can't get your medication because they never got around to doing anything?  Get educated by getting facts, dont rely on Dan Rather for your facts and information.

You are right, fraud is rampant, however you also should report, that as a result, the legit disabledhas jump tru hoops in order to receive durable equipment, people with spinal injury, MS, Post Polio. These are progressive or stable conditions ergo we should not have to through months of paper work questions and doctor visits in order to receive what we need. Please remember we worked payed into the system, not asking for handouts. This not an entitlement program, this ie insurance.
$60 billion dollars a year.  If the Bush family lost this much in fraud, would there be an investigation and stronger quidelines to received medicare payments for services rendered?  What an outrage that a government is not disgraced by this fraud under their administration.  If I lost a fraction of this amount of money, I would not be able to face the people I know for my stupidity.
I was at the dinner table last night with my sister and mum when this piece about 'Medicare Fraud' came on and I was absolutely disguted.  Writing this, I even feel that 'disguted' is such an understatement.  
Reading the other comments, I read one regarding 'National Health Care' and I'm interested as to why you think that would be even worse?  Of course most 'news' is distorted and 'we' the public only seem to get a 'breeze' of other countries healthcare system.  Forgive me but, I rarely hear negatively about Socialized Health Care.  
I'd love to investigate and exploit fraudlant activity in my area if I could regarding Medicare.  If someone can tell me what I can do or where I can start, I'm all about being a whistleblower and making these people pay!
Hurray for NBC News

On two successive nights, NBC news gave extensive time
out of their 20 minutes of evening news to report on stories the "MEDIA OUGHT TO BE SPENDING TIME ON" instead of every dumb political propaganda sound bite and misbehaving celebrity.

I am referring to the story on Friday, Dec 7 about the Canadian who financed and set up Canada Town to help the victims of Katrina.  Then on Monday Dec 10, you followed up with a story on Medicare Fraud.  I could not help but notice that 8 million private dollars went a long way in Canada Town while 5 million taxpayer dollars went for one wheelchair in the Medicare Fraud story.  Think of how far that 60 billion in Medicare Fraud could go to help our physically and mentally disabled veterans!  That is a story combo that could use a lot more coverage.

I think we could go a long way to reducing these fraud problems with some good old capitalistic incentives.  Congress needs to set up a fraud busting task force of FBI and IRS agents and offer rewards of 10 percent of fraud uncovered.  We need fraud sentencing guidelines that take these crimes seriously.
Noridian, the company, contracted by the government,
should be investigated for this fraud occuring.

Recently, Noridian changed their billing form (CMS 1500)which is used nationally and by all insurance
companies. The instructions for completing the form were 20 PAGES, yes, 20 PAGES, and so confusing many prividers have gotten claim kickbacks after kickback from Noridan because of the confusion.   With all Noridian's requirements, it is so difficult to believe that all this fraud was not detected

New Federal Provider Identification (NPI's)  were issued and all providers were required to apply for them and use on the new billings.  These NPI numbers were to be cross checked with the providers old Medicare UPIN numbers and coincide to prevent any fraud.  Has this fraud been overlooked because none of our representatives ever check on Noridian's performance. I don't think any new president or any of our representatives have the backbone to correct all the blunders made by our federal government - immigration, war, healthcare and social security, welfare, the mortgage mess, overpopulation depleting all our resources, escalating gas, food and utility costs that are driving older retired people out of their homes. Our government needs people in office that are not whimps and are able to say "NO MORE"  
I work for an accrediated DME company. We pay for the Community Health Accrediation Program to survey our company. We are heavily regulated and have to follow the rules and regulations of Medicare.  Unlike other fly by night companies selling Durable Medical Equipment. Almost all equipment has to have a prescription from a Medicare certified physician. We are not a wife or family member of an orthopedic, pulmonologist or cardologist selling a CPM machine, oxygen or other durable medical equipment. Also unlike other providers like:  Walgreens, CVS, and Walmart our patients are given explicit instructions on how to use the equipment. Providers need to have an ethical and moral obligation to their patients and unfortunately in todays society there is not much ethics or morals. Just the almighty buck. And there is always a criminal element, just look at the drug dealers now in Durable Medical Equipment in Florida and probably Houston, TX.
The Republicans have always told us "Put us in charge of the management of programs of government because we are professionals and we are better managers.  With such professional management one would expect little to no Medicare fraud.  Could the skill level of Republicans be only so much hot air?
Dear Dr. Edwards,
I'm sorry to hear this.  I think Medicare/Medicaid is broken and it needs to be fixed.  I was reading other bloggers who Medicaid/Medicare has screwed over, so you are not alone.  It seems as if doctors like you, small businesses, and the elderly are the only ones that get punished under this system.  And, being Black and from Mississsippi, I don't think it has anything to do with color.  I know young, healthy people both black and white, who could get off of their asses and work, and who live quite nicely off of Medicaid/SSI disability checks.  I don't know any elderly people, white or black, who have this luxury.  I, personally, have called and called to report just rampant and shameful medicaid/disability fraud in Mississippi.  The people at the office in Jackson laughed at me.  Some even got a little flippant with me.  And then you have to look at the nepotism factor.  Some people "get in good" with Medicaid/Disability workers, and no matter who protests, they don't get caught.  I am so enraged because my Dad is a Vietnam veteran who must pay for medication when he goes to the VA hospital.  My neighbor sits on her ass all day watching soap operas and keeping up shit, does not work, and lives very well on her Medicaid/Disability checks.
Medicare is not interested in receiving reports of possible fraud. I have tried via telephone calls and then their so-called "hot-line" with multiple emails. I have yet to receive a reply from my numerous inquiries over more than a year. Please turn up the heat!
This is the most important domestic issue NBC has uncovered in my lifetime. I found fraudulent medical billing paid on my account as soon as Medicare took on prescription drugs. There is no one to report this to. Call Medicare and an automated message says all lines are busy, call back another time. I have waited on hold for hours, been automatedly disconnected and left messages at medicare contacts trying to report abuse and fraud. The humans I have contacted never follow through. No one is minding the store. We have no government accountabilty. It's a feeding frenzy.
Mark, last year I lost my father of 75 years to Dementia/Alzheimers.  As a 53 year old single woman with only 1 income, I relied on my father's health care resources - VA Benefits, Medicare and Medical.  Since this was my first experience with all of this I had to learn quickly about what each resource would help me with in order to keep my father in my home and out of the neglectful, Medicare "bilking" nursing home care system.  Unfortunately, I had first hand experience at how much fraud there is within the entire system.  For months after his passing agencies sent me medication, nutrition supplements, diapers, and other supplies I used for his care.  I notified them several times that my father had passed and wanted to return the items.  I literally had to argue with them to return them.  All items were in the original boxes and not opened yet they refused to return them.  After months of arguing with them, I was drained and just wrote refused on them.  For months I saw the bills come in from Medicare with outrages charges.  When I complained to Medicare they gave me the run around and frankly did not know how to help me.  Shame on the system. I am so glad that they are now under investigation it's about time!!!!!!!!.  This is a travesty. Thank you for the story.  Hopefully my generation will be angry enough to stop this fraud.  Thank you.  R. Pelletier, 54 Oceanside
I know,I would not get away with any of this for I am to damn honest. Shame on those who do it and our leagal system .
Doc's often denigrate the rest of the Medical service industry, but many of them schedule their patients to return every 30 days like clock work whether the patient needs it or not. That in itself is a form of writing your own paycheck and is illegal vis a vis Medicare rules. Doc's are audited by Medicare only in extreme circumstances. Depending upon the patient's acquiescence, Doc's get to write their own meal ticket as long as they are willing to sign off on enough justification. No other provider can do that. That is the big secret that the AMA is lobbying to hide.  
Just one more post to say that this is no big surprise.  My in-laws are both on the Medicare grift.  Both are "disabled" and attend one certain "pain management" clinic about 4 times a week.  

They spend their SSI checks on travel, big screen TV's and nice cars (we figure between the grifting of the Medicare and the SSI they're probably pulling in around $2500 per month, and of course they don't pay anything for their home either, thanks to HUD), and have been doing so for over 10 years.

My husband finally stopped trying to "save" them, and we've broken all ties with them.  

I reported them and the facility over 3 years ago, on several occasions.  Stating that if they have the ability to sit for long hours in a car, walk for miles while visiting places, and can perform the heavy lifting of suitcases into their car; then they can certainly work and are NOT disabled.

4 years have passed and gee guess what, they're still on the grift.  No action whatsoever.

As a side note, my 70 yr old mother went to the same "pain management" facility last year for a knee injury, on a consult.  They billed for several "proceedures" that never took place.  She never went back and reported them...they're still in business.


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