I promised some examples of Medicare fraud. Here’s a first installment. All quotations are from newspaper articles. I’ve blanked out the names of those who were involved.
2/1/1973: “…proprietor of G & D Surgical and Drug Co, Englewood, NJ, for Medicare fraud; co charged with submitting 66 false claims totaling $13,478.80 for equipment allegedly rented to Medicare patient.”
3/29/1974: “Dr XXX pleads guilty to 10 counts of Medicare fraud.”
I should mention that in some cases of fraud and guilty pleas, doctors may have been filing false reports in order to counteract Medicare regulations that would have harmed the health of their patients.
5/15/1974: “Dr XXX, osteopath who pleaded guilty Apr 15 to 8 counts of Medicare fraud, …”
4/17/1975: “Fed Govt files 1,151-count civil complaint against Dr XXX, charging him with Medicare fraud and asking $2.3-million in damages,… ”
11/25/1975: “…sentences podiatrist Dr XXX and osteopath Dr YYY, who pleaded guilty to Medicare fraud”
5/9/1976: “Nursing home operator XXX sentenced for Medicare fraud”
10/19/1980: “Seven past or present officials of Roosevelt Memorial Hospital have been charged with taking part in one of the largest Medicare and Medicaid fraud schemes ever uncovered, the United States Attorney’s office said today.”
11/17/1980: “A House committee has charged that the Medicare program is losing about $2 billion a year in outright fraud…”
“Cash kickbacks to doctors and nursing home operators, paid by health-related providers who benefited when patients were given unnecessary services, was the most common kind of Medicare fraud, according to report by the House Select Committee on Aging…”
“One doctor ordered so many unnecessary blood tests that he was given the nickname ‘Dracula’ investigators said. Similarly, a high level of fraud was found in the companion Medicaid program. One doctor received $2 million in Medicaid payments over two years for performing”abortions” on women who were not pregnant. The women were misled about the results of their pregnancy tests.”
“The report gives details of a variety of kickbacks, false billings and other fraudulent practices involving doctors, clinical laboratories, nursing homes, hospitals and pharmacies.”
”’Corruption has permeated virtually every area of the Medicare and Medicaid health care industry,’ Francis Mullen, assistant director of the criminal investigative division of the Federal Bureau of Investigation, told the committee. ”The people committing these frauds have absolutely no fear of being caught.'”
The fear level is low because the government cannot possibly pay the costs of monitoring all the medical transactions in the country. It therefore does not do what it cannot do.
This 1980 report is one of many such reports. Another one, equally critical, comes up in 1991.
12:29 pm on October 26, 2012
