Great EXAMPLE of Fraud in our Medicaid system

[url]http://www.foxnews.com/us/2011/09/14/wheelchair-bound-vietnam-vet-uncovers-multimillion-dollar-medical-aid-fraud/?intcmp=obinsite[/url]

I wonder HOW much of this crap exists.

Reminds me of my stay in the hospital in 2008 when I was diagnosed with Type I Diabetes.

Some smarmy foreign doctor would enter my room, grin a whole lot and then leave. Turns out it cost me $350.00 every time this jerk entered my room. For what??

Don't even get me started on the $50.00 a dose for my blood pressure medication that I was not allowed to bring from home.

All the nurses were great and very helpful and my diabetes doctor knew her stuff, but all the other lookie loos were just parasites draining my wallet.

That crap ticks me off.

Another thing about many doctors (not all) I have installed systems for is that they are cheap and expect the world. Trust me I don't cut them a break on anything!! I get more satisfaction out of giving my proposal and they can take it or leave it and if they leave it then fine.....let someone else deal with them. Sorry a little off topic...

Yes!!!!!!!

I am the guardian for an adult with a severe disability. I oversee his care and living conditions.

The cost that are billed each month to Medicaid are unbelievable. Care providers bill in "units" that are actually a 15 minute visit. Every service is billed in a code, so even if I try to audit a monthly bill it is next to impossible to identify services received without the master code book to convert services to the proper code.

Since so many services have been "contracted" out to private health care firms, the checks and balances have all but disapeared.

Any reports to medicaid of billing irregularities are met with resistance. As there are very few alternitives to care providers you get the feeling Medicaid does not want to look at problems too deeply as they are not capable of providing an alternate service provider.

Prime example: Several months ago I found that all of the light bulbs in his room were burned out. I reported to the care provider he needed his light bulbs replaced. I had searched the house and there were no replacement bulbs in the house. The next week I checked on him again and the lights were still out. Again I brought this to the attention of the care provider, another week and no action. I replaced all the burnned out bulbs in the house after he was in the dark for two weeks.

This month I checked on him and found that two of the smoke detectors in the house were chirping constantly because the batteries were bad. I informed care provider the smoke detectors needed new batteries. Another week passed and I found the detectors still chirpping. Not only were these things very annoying for someone trying to sleep I was a dangerous situation in that the house had no smoke detection.

Here is how it was handled. The worker reported it to the staff coordinator. The staff coordinator reported it to the residential services supervisor the next week. The supervisor forwarded the report to the maintenence crew (after about 4 days). The maintence crew added it to the job works pending and this is where it is today.

I replaced the batteries myself and now I am just waiting to see how long it will take them to realise that these have already been replace.

The worker in the house told me that they were not permitted to have spare light bulbs (or batteries) in the house and that all maintenence issues had to be requested through supervisors.

So in essence it takes no fewer that 5 persons to replace a light bulb or change a battery with each of these persons billing Medicaid in 15 minute units for their time.

Lord watch out for those that do not have a gaurdian looking out for their interests.

Congrats to you for stepping up and helping someone who needed it. Hard to believe people can be so selfish not to help a fella who can't help himself. Sometimes you have to just take care of business.....good job!

I personally feel your whole health care system needs a major overall. Dont think Obama is capable of handlling this but when I have read how this system has treated Elnut and robbed him dry of all his money and assets it is a darn shame and very discouraged that this happens. So much for health insurance. It obviously doesnt work very well. Just my 2 cents as I am passing by.

[QUOTE=Big Gills;466167]I personally feel your whole health care system needs a major overall. Dont think Obama is capable of handlling this but when I have read how this system has treated Elnut and robbed him dry of all his money and assets it is a darn shame and very discouraged that this happens. So much for health insurance. It obviously doesnt work very well. Just my 2 cents as I am passing by.[/QUOTE]

Not an INSURANCE issue, if you ask me...........

I think PROVIDERS are the root problem........but they have been trained to over bill by the very nature of Medicare and Medicaid. When the gubment pretty much doesn't deny any payment, well creative providers find ways to make an extra buck.

If you eliminated ALL government components of healthcare, I bet the cost would drop significantly. If folks PAID for everything themselves, then providers would charge significantly less, or they'd go out of business. Not very may people are going to pay 2500 out of pocket for an allergy test, or 5000 for a MRI, or 12,000 per dose for the latest/greatest cancer treatment.

Give government incentives for HSA's......tax breaks and allow folks to save more than 6k a year in a HSA. Allow them to invest in the HSA as much as they want. When they turn a certain age, if they've not used all their saved medical, allow them to pay a lower tax rate on it, and convert it to a retirement account.

As they sit today, HSA's barely cover the expenses I incur a year.

I need way more than 6k, and I'd LOVE for them to cover additional alternative medicines........I'd love for it to cover herbal remedies. I have found a very specific treatment for migrane and sinus headaches that costs nearly 250 a month but I'm not using it because my HSA will not cover it, and I don't want to pay 250 totally out of pocket........****.


Later,

Geo

Well, that is one of the sad things in reality. How will the patients cure from their illnesses? A while ago I had read from here: [URL="http://www.newsytype.com/14892-pharmaceutical-medicare-fraud/"]Pharmaceutical Medicare and Medicaid fraud runs rampant[/URL] that the pharmaceutical sector is often a case of Dr. Jekyll and Mr. Hyde. On one side, they produce and make drugs that many people need to survive. On the other, they are increasingly connected to a litany of abuses, including rampant Medicare and Medicaid fraud.

How about the freebies? Transients who have no coverage going into the ERs and getting FREE medical service.Ever try to get a quick doctors appointment? Get a diagnosis with out a costly test?My doc told me its CYA medicine.His malpractise insurance rates are sky high, and hes only a GP with no action taken against him. Dont mention frivolous malpractsie suits. Aint no such thing hardly anymore. I contested a charge, and told them they had made a mistake in the recovery room, "no record" they said.So they ignored me, charged my medical insurance, and medicare, and turned it over to a collection agency. My companion has frequent blood transfusions. One medico, uses his practise, and charges 3 times the amount the hospital charges.[we dont see him anymore].The system is broke, has been for years. Insurance companys and uncle sugar are the biggest culprits, but there is larceny in many a patients soul also.