We bring this up because one of the burdens of being disadvantaged in the country is having to live with the indignity of being regularly accused of committing fraud. Yet, it’s the power elite themselves who commit most of it – and often victimizing the disadvantaged while doing it.
Workers compensation is another example. In the early 1990s, insurers and businesses began trumpeting up distorted rhetoric around the idea of “fraudulent” workers’ compensation claims, greatly exaggerating the extent of the problem (maybe 1 to 2 percent of claims). Yet fraud is most likely caused not by workers, but by employers - underreporting payroll, declaring employees as independent contractors, misclassifying occupations, and misrepresenting claims experience. See more here.
There’s no area where that’s more true than health care fraud. For example, on Thursday, AP reported on the U.S. Justice Dept.'s announcement of another big health care fraud settlement, specifically,
Boehringer Ingelheim Pharmaceuticals Inc. will pay $95 million to settle allegations that the company promoted three drugs for uses that were not medically accepted.… Thursday's announcement is the latest in a series of settlements with pharmaceutical companies engaging in so-called off-label marketing. In the law enforcement initiative's biggest case, GlaxoSmithKline agreed to pay $3 billion and pleaded guilty to promoting two popular drugs for unapproved uses and to failing to disclose important safety information on a third.
See more here.
Also this week,
The owner of a Miami health care agency was sentenced on Oct. 23, 2012 to 37 months in prison for his participation in a $60 million home health Medicare fraud scheme … Rodolfo Nieto, Jr., 40, of Miami …was the owner and operator of Ronat Home Health Care Inc. According to court documents… from approximately January 2006 to approximately November 2009, Nieto accepted kickbacks in return for recruiting Medicare beneficiaries to be placed at Nany Home Health Inc., a Miami home health agency that purported to provide home health care and physical therapy services to eligible Medicare beneficiaries. The owners and operators of Nany paid Nieto kickbacks in return for allowing Nany to bill the Medicare program on behalf of the patients Nieto had recruited through Ronat. Specifically, as part of the scheme, Nany billed Medicare for home health services purportedly provided by Ronat.
Joining the crowd, “A Dover [DE] psychiatrist who was accused of improperly prescribing painkillers and defrauding the state’s Medicaid program admitted guilt today and was fined and sentenced to a year in prison."
It never seems to stop. In fact, that was the message of a Today Show segment today, finding that, "Federal agents arrest a health care fraudster nearly every day, charging close to 1,500 people last year alone.” In many cases, these crooks are billing Medicare for services never provided, and “victims are elderly and disadvantaged.”
If you see Medicare fraud, HHS is asking you to call its tip line: 1 800 hhs tips. I would image a good tip might be a doctor who bills Medicare for tests that are not "medically indicated or for the health of the patient." They like to call such tests “defensive medicine.” Actually, it’s fraud.
That number again? 1 800 hhs tips.