Medicaid Fraud in NY

[chanel]

A year after a congressional audit exposed exorbitant fraud and abuse in the federal government’s insurance program for the poor, the Justice Department is suing New York City for cheating it out of tens of millions of dollars in the last decade.

Corruption in the Medicaid program is nothing new but the complaint, filed this week by the U.S. Attorney in Manhattan, indicates the problem is much worst than previously reported. Federal authorities claim that nearly 18,000 people in the city received costly, taxpayer-financed personal care services that should not have been covered or weren’t medically necessary.

The government was billed between $75,000 to $150,000 a year for the special services that include 24-hour aides that help with housecleaning, shopping, bathing and other personal needs.

About a year ago a congressional report included New York as one of five states with the highest rate of Medicaid fraud. During a two-year investigation, 65,000 instances of prescription fraud cost U.S. taxpayers about $65 million in the top five states alone. An additional $2.3 million went to practitioners and pharmacies banned from federal health care programs, nearly 2,000 prescriptions were written for dead patients and 1,200 prescriptions were written by dead doctors.

New York's Medicaid system is the largest and most expensive (around $48 billion annually) in the nation because it extends benefits to the middle class and allows excessive use of certain costly services that aren’t always related to medical care.

Additionally, the state’s Medicaid program has been cheated by several criminal rings that duped it into paying tens of millions of dollars to give bodybuilders a costly muscle-building drug intended for AIDS patients and to provide Viagra for hundreds of sex offenders. Some may wonder what took the feds so long to take action.

Feds Sue N.Y. For Millions In Medicaid Fraud | Judicial Watch

What a system.

 

[Madeline]

Things are so bad in Florida, it is widely reported many former drug dealers have gone into Medicaid fraud instead because the penalties if caught are so much lower and the effort involved so much less.

Durable medical equipment is a perennial favor; many an oxygen tank has been delivered to the an address in the middle of the Miami River. Apparently home health care is the same -- both likely for the same reason, because no medical professional need be involved.

I think we should allow private practice lawyers to sue for this fraud, and to keep a third of what they collect. If the government can't or won't pursue fraud, let the young turks have at them.

 

[Christopher]

Unfortunately, this is only the tip of the iceberg. Medicare is also big target for fraudsters.
Health care fraud costs Americans $100 billion - Jan. 13, 2010

Published reports late last year said about $47 billion were made in questionable Medicare payments.

 

[beennasuna]

Everyone is too obsessed about Medicare fraud. Obama is eager as hell to cut Medicare spending and deny our grandparents healthcare, but the Medicaid abuse and fraud is shoved under the rug.

 

[uscitizen]

Just make the penalty 100% of the profit made thru fraud plus any regular penalties.

If the maximum fine is 100k and you make 1 million...