Medicare/Medicaid Fraud: Undercover Grandmother Exposes MAJOR Fraud!Laws
It is an unfortunate truth in medicine that fraud exists, particularly with Medicare and Medicaid. The law has created very specific guidelines for both of these reimbursement methods and whole industries of lawyers work on compliance with this guidelines. Unfortunately, there are whole industries of lawyers who also work on prosecution of these claims. It is estimated that health care fraud costs the United States government at least $60 billion a year!
This week, federal authorities announced the investigation accusing seven health care professionals of Medicare and Medicaid fraud. Many of these incidents of fraud were actually done with test or undercover patients who would report to a physician for a checkup appoint, and then later request the medical records from that appoint only to find gross discrepancies in the visit and what was recorded on the chart. Subsequently, this would be reported for reimbursement by the health care provider who would wrongfully receive money from the government for procedures or conditions they did not treat.
On of these undercover investigators was an elderly grandmother who was in excellent health who went into a checkup with an assistant. The whole visit was secretly recorded by an assistant to the grandmother and reported here: http://gma.yahoo.com/video/news-26797925/exclusive-undercover-grandma-and-medicare-fraud-28476179.html. It is a great short clip, please watch!
Additionally, the investigation found that one physician in particular, Jacques Roy, was allegedly “selling his signature” to collect both Medicare and Medicaid payments for work that he never actually did or on procedures which were not necessary. This investigation was actually going on from 2006 to 2011, and was just unsealed (making it public) this week for formal prosecution. In fact, the investigation found over 11,000 bills in a year, which—investigators claim—is just not physically possible to do. Of course, it is important to note that Dr. Roy is innocent until proven guilty, and these are just allegations of fraud and not facts of fraud.
But what do you think? I’d love to hear from you. I welcome your phone call on my toll-free cell at 1-866-889-6882 or you can drop me an e-mail at firstname.lastname@example.org. You are always welcome to request my FREE book, The Seven Deadly Mistakes of Malpractice Victims, at the home page of my website at www.protectingpatientrights.com.