Scum bags who commit fraud against our country - page 3

With all the issues we have with "entitlement" programs like Medicare and Medicaid, we don't need *** like these people making things worse. Are these people American citizens to begin with? It seems... Read More

  1. by   herring_RN
    [FONT=Univers-CondensedLight-spPDF][FONT=Univers-CondensedLight-spPDF]August 5, 2011Standard and Poor's downgraded the credit rating of the United States.
    Read the S&P report

    ... The U.S. lost its esteemed AAA credit rating after being downgraded by Standard & Poor's Friday, eroding the elite standing it has held in global markets for more than 70 years.

    The nation's credit rating was cut to AA+ after S&P said the compromise made by Congress and President Obama this week to cut spending and boost the debt ceiling "falls short of what, in our view, would be necessary to stabilize the government's medium-term debt dynamics."

    S&P's statement was blunt in its assessment.

    "We lowered our long-term rating on the U.S. because we believe that the prolonged controversy over raising the statutory debt ceiling and the related fiscal policy debate indicate that further near-term progress containing the growth in public spending, especially on entitlements, or on reaching an agreement on raising revenues is less likely than we previously assumed and will remain a contentious and fitful process," the ratings firm said. ...
  2. by   Spidey's mom
    Quote from ixchel

    I learned this semester you can bill insurance for telling someone to quit smoking. Funny enough, even non-smoking inpatients have "smoking cessation education" in their orders at the hospital. Who tells the insurance companies that never happened or never was needed? No one. I just hoped that it doesn't come back on the patients somehow that they were flagged as smokers at some point in their medical histories. Is that possible?

    Ah . . one very frustrating thing I've learned since becoming a school nurse is we bill Medi-Cal for things as district employees. It is called MAA . .. .I call it pimping for Medi-Cal.

    The things we can bill for are ridiculous.
  3. by   carolinapooh
    Yet people have the nerve to say there shouldn't be more control over health care in this country. Well, not saying the Feds are necessarily the right answer, but the private sector sure seems to have run the quality of care in the toilet compared to many other industrialized nations (most, really), giving us poorer outcomes in comparison, all while skyrocketing costs out of control to the point that we spend more money per head on health care in this country than any other industrialized nation. And really, we have nothing to show for it except exorbitant bills, wealthy MDs, and people in bankruptcy because they had the nerve to become seriously ill with, I don't know, cancer that they couldn't possibly have any control over developing or not developing. Even if they could control it, does someone deserve to lose every single thing they own just because they got sick? People in this country do not realize this is the ONLY place on the planet that happens. Even other countries don't believe it!

    Go to YouTube or PBS' website and watch 'Sick In America' from Frontline, then watch 'Sick Around the World'. Be prepared to be physically ill. No pun intended.
  4. by   herring_RN
    Medicare fraud reported since Christmas:

    December 31, 2013; U.S. Department of Justice Colorado Health Care Organization and One of Its Montana Hospitals to Pay $3.85 Million for Allegedly Providing Financial Benefits to Referring Physicians and Physician Groups
    St. James Healthcare (St. James), a hospital located in Butte, Mont., and its parent company, Sisters of Charity of Leavenworth Health System (Sisters of Charity), a health care organization based in Denver, Colo., have agreed to pay $3.85 million to resolve allegations that they violated the Anti-Kickback Statute, the Stark Law and the False Claims Act by improperly providing financial benefits to physicians and physician groups that made referrals to the hospital, the Justice Department announced today.

    December 27, 2013; U.S. Department of Justice Abbott Laboratories Pays U.S. $5.475 Million to Settle Claims That Company Paid Kickbacks to Physicians
    Abbott Laboratories has agreed to pay the United States $5.475 million to resolve allegations that it violated the False Claims Act by paying kickbacks to induce doctors to implant the company's carotid, biliary and peripheral vascular products, the Justice Department announced today. Abbott is a global pharmaceuticals and health care products company based in Abbott Park, Ill.

    December 26, 2013; U.S. Attorney; District of Arizona Rural/Metro to Pay $2.8 Million to Resolve False Claims Allegations
    PHOENIX - Rural/Metro Corporation, a Delaware corporation that through its subsidiaries and affiliates provides private ambulance and fire protection services in Arizona and approximately 20 other states, has agreed to pay the United States $2,802,112 to resolve civil allegations that various Rural/Metro ambulance companies violated the federal False Claims Act by submitting false bills to Medicare.
  5. by   toomuchbaloney
    A new year, 2014, with ongoing fraud:
    25 Charged in Largest Medicaid Fraud Bust in D.C. History « CBS DC
    "Federal authorities say 25 people have been charged in a wide-ranging scheme to obtain millions of dollars in fraudulent Medicaid payments from the District of Columbia government."

    Examples of Healthcare Fraud Investigations - Fiscal Year 2014
  6. by   Hoosier_RN
    Quote from imintrouble
    I would guess that those of us with more than ten years of experience, have at some point in our career, witnessed flagrant medicare/medicaid fraud.
    How many of us reported it?
    I did. Lost my job. Boss said I harassed the member to get there info. The member's own family turned them in. It really ruined my self esteem and morale for awhile. Oh well Karma can be ugly.....
    Last edit by Hoosier_RN on Mar 6, '14 : Reason: spelling
  7. by   toomuchbaloney
    Refusing to participate in unethical or unlawful behavior has cost me at least 2 jobs in my long career. The aftermath of those decisions is always difficult filled with self doubt and plenty of self criticism.

    Most of that is healed when another job is secured.

    Stable employment is so important for our emotional health and long term unemployment is so dangerous to it, no matter the reason.
  8. by   WJFD
    Truth is anyone who works for pharmaceutical companies as a sales rep has bribed a doctor. Whether intentionally or unintentionally it happens every single day. Physicians who receive gifts, payments for speeches, trips for "learning" are all being bribed. As a person who was one of those so called "scum bags" that was convicted of kick backs in the last few years I have seen the good and bad of health care. I also see MAJOR hypocrisy. The line between a bribe and a sales pitch is razor thin. In the eyes of the law if you have ever asked for a physician for business and have provided anything as small as a lunch then you have committed a felony.