Sunday, March 06, 2011

Most health care professionals do good, some do very well badly

Guambat reckons we just need to pay these folks more?

Atlanta doctor indicted for Medicaid, Medicare fraud
While under contract to provide group psychological therapy to nursing home patients, Dr. Williams, 72, filed about 95,000 Medicare and Georgia Medicaid claims and was reimbursed about $1 million, according to the U.S. Attorney's Office in Atlanta.

Many of the claims filed during a two-year period beginning in the summer of 2007 were fraudulent, U.S. Attorney Sally Quillian Yates said. In some cases, the patients were dead by the time he reported seeing them, she said. In other cases, they were in the hospital and could not have appeared in the nursing home for therapy as claimed.

Brian D. Lamkin, an FBI special agent involved with the case, said such fraud costs the government and private insurers billions. Acts of "sheer greed" such as those alleged against Dr. Williams are "driving up healthcare costs and are depriving those that really need medical help," Lamkin said.

Pharmacist allegedly netted $3.5M in fraud scheme
John D. Love of Brazil, the owner of the Terre Haute Prescription Shop, faces one count of health care fraud and two counts of money laundering. U.S. Attorney Joe Hogsett said.

The scheme was the largest case of health care fraud and money laundering ever discovered in the Southern District of Indiana, Hogsett said during a news conference Friday.

"I want to make it loud and clear, that when individuals, who through their own greed, take advantage of the health care system for their own greed, take benefits intended to serve the neediest of Indiana's citizens, it will not be tolerated," Hogsett said.

A tip from an outside contractor uncovered information in an audit that prompted the investigation by the Federal Bureau of Investigation, the state's Medicaid Fraud Enforcement Unit and other agencies, Shepherd said.

Investigators said Love would enter bogus prescriptions in Indiana's Medicaid system, wait for his claims to be submitted, and then void them before others could see the orders had not been filled. Love billed Medicaid for more than 6,800 units of various prescription drugs from January 2006 through September 2010, while actually ordering only 156 units of the same drugs.

Love used at least $3 million of the profits to pay for four parcels of land, 15 vehicles, a wedding for one of his children and other personal expenses, prosecutors said. Federal authorities have seized property including five Harley Davidson motorcycles, two sports cars, four SUVs, two pickup trucks, one recreation vehicle and funds from multiple bank accounts.

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