The needy and the greedy


Dozens Arrested in Medicare Fraud Totaling $251 Million
New York Times, 2010-07-17


Federal authorities said Friday that
they had arrested dozens of suspects in five states
on charges of defrauding Medicare of a total of $251 million.

Several doctors and nurses were among those arrested
in Miami, New York, Detroit, Houston and Baton Rouge, La.,
accused of billing Medicare for unnecessary equipment, physical therapy
And H.I.V. treatments that patients typically never received.
Ninety-four suspects were indicted, and the authorities said
36 people had been arrested as of Friday morning.

More than 360 agents participated in Friday’s raids,
which were announced by Attorney General Eric H. Holder Jr.
and Kathleen Sebelius, the secretary of health and human services,
at a meeting in Miami on preventing health care fraud.
The authorities indicted 33 suspects in the Miami area,
accusing them of defrauding Medicare of about $140 million.

“With today’s arrests we’re putting would-be criminals on notice:
health care fraud is no longer a safe bet,” Mr. Holder said Friday.

Cleaning up an estimated $60 billion to $90 billion a year in Medicare fraud
will be an important part of paying for
President Obama’s overhaul of the health care system.
Around the country, the fraud has evolved far beyond simple scams in which
clinic owners billed Medicare dozens of times for the same wheelchair,
while never giving the medical equipment to patients.
Now, officials say, the schemes involve a sophisticated network of doctors, clinic owners, patients and patient recruiters.

Violent criminals and mobsters are also tapping into the scams,
seeing Medicare fraud as more lucrative than dealing drugs
and having less severe criminal penalties, officials said.

For instance, agents bugged a medical center in Brooklyn,
where eight people are charged with running a $72 million scam
that submitted bogus claims for physical therapy
for elderly Russian immigrants.
Clinic owners paid patients, including undercover agents,
in exchange for using their Medicare numbers
and a bonus fee for recruiting new patients.
Recording devices captured hundreds of kickback payments in a private room
where a man sat at a table and did nothing but pay patients all day,
the authorities said.

The so-called kickback room
had a poster on the wall resembling Soviet-era propaganda,
showing a woman with a finger to her lips and two messages in Russian:
“Don’t Gossip” and
“Be on the lookout: In these days, the walls talk.”


The real Medicare villain
By Matt Miller
Washington Post Op-Ed, 2012-08-24

[This is really an excellent column.
Mr. Miller has been publishing excellent work.]

Republicans cry that President Obama
is raiding Medicare to fund a socialist health-care nightmare.
Democrats blast the GOP for
sticking grandma with vouchers
to wreck a program they’ve secretly loathed for decades.
Far be it from me to put the kibosh on all this drama,
but when it comes to the policy stakes,
such breathless charges are beside the point.

The real Medicare villain is not Barack Obama,
and it’s not even “evil” Paul Ryan.
The real villain is America’s medical-industrial complex
and once you grasp this, everything changes.

The beginning of wisdom on Medicare’s future starts with
two things both parties say
but which can’t simultaneously be true.

The first is that
we spend much more on health care than any other advanced nation
yet get no better results.

The second claim —
implicit in the attacks on Obama’s $716 billion in “cuts”
or on Romney/Ryan’s heartless vouchers —
is that,
if we do much to slow the growth of health-care spending,
we’d hurt seniors’ access and quality of care.

As I’ve argued before, no matter how often and how loudly
interest groups and politicians scream this second claim,
it can’t be true if the first claim is a fact.
And U.S. health care’s inefficiency is indisputable.


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