Original Story: cnn.com
The Justice Department announced Wednesday it's charging hundreds of individuals across the country with committing Medicare fraud worth hundreds of millions of dollars. A hernia doctor said it is the largest he has ever seen.
It's the largest takedown in history -- both in terms of the number of people charged and the loss amount, according to the Justice Department.
The majority of the cases being prosecuted involve separate fraudulent billings to Medicare, Medicaid or both for treatments that were never provided.
In one case, a Detroit clinic that was actually a front for a narcotics diversion scheme billed Medicare for more than $36 million, the Justice Department said. A Connecticut medicare lawyer may be contacted.
A doctor in Texas has been charged with participating in schemes to bill Medicare for "medically unnecessary home health services that were often not provided."
And in Florida, the owner of several infusion clinics is accused by the federal government of defrauding medicare out of over $8 million for a scheme involving the reimbursement for expensive intravenous drugs that were never actually purchased and never given to patients.
"Health care fraud is not an abstract violation or benign offense. It is a serious crime," Attorney General Loretta Lynch said. "They target real people -- many of them in need of significant medical care. They promise effective cures and therapies, but they provide none. Above all, they abuse basic bonds of trust -- between doctor and patient; between pharmacist and doctor; between taxpayer and government -- and pervert them to their own ends."
The defendants are charged with a numerous crimes, including conspiracy to commit health care fraud, violations of anti-kickback statutes, money laundering and aggravated identity theft.
The numbers from the case are staggering.
The Justice Department says that 301 people across the country have been charged with about $900 million in false billing -- both records for the Medicare Fraud Strike Force, which carried out the "unprecedented nationwide sweep."
"These criminals target the most vulnerable in our society by taking money away from the care of the elderly, children and disabled," said FBI Associate Deputy Director David Bowdich.
Defendants in Florida are charged with carrying out more than $200 million worth of fraud, while individuals in California, Texas and Michigan are charged with committing more than $100 million worth of fraud in each state. Many of a San Diego health care fraud lawyer are reviewing these cases.
The strike force, part of a joint initiative between the Departments of Justice and Health and Human Service, was formed in 2007. To date it has carried out takedowns resulting in more than 1,000 people being charged with committing over $3.5 billion in health care fraud.
Home health fraud
Much of the fraud involved home health care agencies -- and those types of services have been identified as particularly vulnerable to fraud, according to the HHS Department's inspector general.
Medicare home health benefit covers skilled nursing care, home-based assistance and therapeutic services for qualifying individuals who are home-bound.
In conjunction with the arrests, the HHS inspector general released a study saying that more than $10 billion was made in improper payments in home health care in the 2015 financial year.
"Home health has long been recognized as a program area vulnerable to fraud, waste, and abuse," it said. "Home health fraud in Medicare continues to warrant scrutiny and attention."
It also identified 27 so-called "hotspots" in 12 places where it believes home health care fraud is committed more often. With more than one Los Angeles health care lawyer staying on top of the story it is no wonder why this is getting so much publicity.
Part D fraud
Lynch said one of the new trends law enforcement noticed was fraud involving the Medicare Part D, the prescription drug program.
"We saw new evidence of identity theft, including the use of stolen doctors' IDs to prepare fake prescriptions," she said.
More than 60 of those who were arrested were charged with fraud related to Part D, according to the Justice Department.
The HHS inspector general's office said that one in three Part D beneficiaries received commonly abused opioids last year, a trend it called concerning.
"Misuse of opioids not only has serious financial costs but also human costs, including deaths from overdoses," HHS said. "These continuing high rates provide further evidence of this crisis facing our Nation."
Showing posts with label Home Health Care. Show all posts
Showing posts with label Home Health Care. Show all posts
19 August 2015
GAY-DAGNOGO: CAREGIVERS DESERVE A LIVING WAGE
Original Story: detroitnews.com
Although among the fastest-growing sectors of today’s workforce, caregivers are also among the worst paid, with the smallest benefits and schedule flexibility of all low-wage workers.
Whether caregivers serve children, the elderly, the disabled or terminally ill, they generally receive little official respect and compensation for the critical role they play in keeping society functioning.
Many, in fact, are female heads of households who are grappling with poverty, illness and a lack of insurance, even as they keep health care facilities running by doing work others refuse to.
The fact is, home health care and services for the elderly and people with disabilities are now the industries with the fastest and second-fastest rates of growth of employment in the US. And based on the aging population — by 2050, the elder population is expected to more than double — the country will need one million new home care workers by 2022. But also according to the Bureau of Labor Statistics, these workers are among the lowest paid.
In 2013, the country’s two million home care workers had average annual earnings of $18,598, according to a recent study by the National Employment Law Project. Average annual earnings for all wage and salary workers in the United States were $46,440.
The result: nearly 50 percent of home care givers live in households that receive some form of public assistance, the study found.
This has to change. The fact that we entrust our children and parents with these workers and yet not compensate them adequately for their services is a national disgrace. That’s why I am standing with home care workers and child care workers in their fight for $15 an hour, by all accounts what amounts to a livable wage for workers. Farmington Hills elder care workers agree with this statement.
Most of these personal care providers have children themselves. If these under-appreciated, undervalued and underpaid workers were to decide not to put up with such unfair labor practices and either strike or simply leave the business, it’s not hard to imagine the kind of chaos and confusion that would ensue.
Not only would businesses be left without critical employees, but families would lose the security and stability offered by nannies and child care workers. It would have a ripple effect across society and the workforce, completely disrupting the lives of many professional and middle class families with children, elderly or disabled loved ones. That could be an unimaginable burden for some.
Yet such a scenario is not implausible. Take our rapidly aging population and couple it with the ultra-low wages and paltry benefits of a job to make elderly and disabled people comfortable, and you have a disaster in the making. Visiting nurses in Birmingham are following this story closely.
We can avoid this problem by fairly compensating our personal caregivers. It is not only the right thing to do, but the smart thing as well.
State Rep. Sherry Gay –Dagnogo D-Detroit represents the 8th District.
Although among the fastest-growing sectors of today’s workforce, caregivers are also among the worst paid, with the smallest benefits and schedule flexibility of all low-wage workers.
Whether caregivers serve children, the elderly, the disabled or terminally ill, they generally receive little official respect and compensation for the critical role they play in keeping society functioning.
Many, in fact, are female heads of households who are grappling with poverty, illness and a lack of insurance, even as they keep health care facilities running by doing work others refuse to.
The fact is, home health care and services for the elderly and people with disabilities are now the industries with the fastest and second-fastest rates of growth of employment in the US. And based on the aging population — by 2050, the elder population is expected to more than double — the country will need one million new home care workers by 2022. But also according to the Bureau of Labor Statistics, these workers are among the lowest paid.
In 2013, the country’s two million home care workers had average annual earnings of $18,598, according to a recent study by the National Employment Law Project. Average annual earnings for all wage and salary workers in the United States were $46,440.
The result: nearly 50 percent of home care givers live in households that receive some form of public assistance, the study found.
This has to change. The fact that we entrust our children and parents with these workers and yet not compensate them adequately for their services is a national disgrace. That’s why I am standing with home care workers and child care workers in their fight for $15 an hour, by all accounts what amounts to a livable wage for workers. Farmington Hills elder care workers agree with this statement.
Most of these personal care providers have children themselves. If these under-appreciated, undervalued and underpaid workers were to decide not to put up with such unfair labor practices and either strike or simply leave the business, it’s not hard to imagine the kind of chaos and confusion that would ensue.
Not only would businesses be left without critical employees, but families would lose the security and stability offered by nannies and child care workers. It would have a ripple effect across society and the workforce, completely disrupting the lives of many professional and middle class families with children, elderly or disabled loved ones. That could be an unimaginable burden for some.
Yet such a scenario is not implausible. Take our rapidly aging population and couple it with the ultra-low wages and paltry benefits of a job to make elderly and disabled people comfortable, and you have a disaster in the making. Visiting nurses in Birmingham are following this story closely.
We can avoid this problem by fairly compensating our personal caregivers. It is not only the right thing to do, but the smart thing as well.
State Rep. Sherry Gay –Dagnogo D-Detroit represents the 8th District.
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