Medicare Fraud is a Never Ending Story

A most Sad issue since it is many of those in the Medical Industry that are doing it. By their fraudulent actions, many are being denied the medical care they need and/or the government debt is being increased. (Debt in America: Real Time)

Here are just a few for July 27, 2015

A Public Awareness Issue shared
by the National Family Advocacy Team.

OIG posts two reports and enforcement actions 07/27/2015 Today, OIG posts two reports and enforcement actions. As always, you can use the links provided to go directly to the new material. ------------ Reports Medicare Contractors' Payments to Providers for Hospital Outpatient Dental Services in Jurisdiction K Did Not Comply With Medicare Requirements (A-06-14-00022) http://go.usa.gov/37peH Medicare contractor payments to providers in Jurisdiction K (Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, and Vermont) for hospital outpatient dental services did not comply with Medicare requirements. Of the 100 dental services in our stratified random sample, 85 did not comply with Medicare requirements. Using our sample results, we estimated that Medicare contractors improperly paid providers at least $2,276,853 for dental services provided during the period January 1, 2011, through December 31, 2013. ### Hospice of New York, LLC, Improperly Claimed Medicare Reimbursement for Some Hospice Services (A-02-13-01001) http://go.usa.gov/37peV Hospice of New York, LLC (the Hospice), operating in New York State, claimed Medicare reimbursement for some hospice services that did not comply with certain Medicare requirements. Of the 100 beneficiary-months in our random sample for which the Hospice claimed Medicare reimbursement, 79 beneficiary-months complied with Medicare requirements, but 21 did not. We estimated that the Hospice received at least $1.3 million in improper Medicare reimbursement. ---------------- Enforcement Actions Owner of Detroit Home Health Care Companies Sentenced to 80 Months in Prison for Role in $12.6 Million Fraud Scheme (July 24, 2015; U.S. Department of Justice) http://go.usa.gov/3wjCE Stockton Oncologist Pays $736,000 to Resolve False Claims Act Allegations (July 24, 2015; U.S. Attorney; Eastern District of California) http://go.usa.gov/3wjCE Board Certified Obstetrician And Gynecologist Agrees To Civil Fraud Settlement In Conjunction With Deferred Prosecution In Medicare And Medicaid Fraud Investigation (July 24, 2015; U.S. Attorney; Eastern District of New York) http://go.usa.gov/3wjCE Dallas County Woman Admits Defrauding Medicaid (July 24, 2015; U.S. Attorney; Northern District of Texas) http://go.usa.gov/3wjCE ---------------- If we can be of any further assistance, please send an email to public.affairs@oig.hhs.gov . OIG’s privacy policy can be found at http://oig.hhs.gov/notices/privacy-notice.asp

Nuff Said, yes? ~~~~~~~~~~ Like GPC Publication onFB   National Coordinator of the Family Survey Program When One Deals with the Child Protective AGENCY>>;LearnMore

National Medicare Fraud Takedown Results

As the Senior Editor of GPC Publications, periodically, like to share the Medicare Fraud that is going on; and the Agency that is Responsible for Catching those that do.
Noting, and imagine that it is not the Government that is Frauding Medicare, BUT the Private Hospitals, Doctors, etc.



BTW, in regards to the Child Protective AGENCY, there is much fraud going on, but to date many have missed it. Much of it is related to Targeted Case Management. Check out this Animated Video as an Introductory to the issues>> The Anatomy of Child Welfare Fraud >> https://www.youtube.com/watch?v=YNTa7BksGkg

Anyway, here are some Enforcement Actions

National Medicare Fraud Takedown Results in Charges Against 243 Individuals for Approximately $712 Million in False Billing http://go.usa.gov/3pcbk

Attorney General Loretta E. Lynch and Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell announced today a nationwide sweep led by the Medicare Fraud Strike Force in 17 districts, resulting in charges against 243 individuals, including 46 doctors, nurses and other licensed medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $712 million in false billings.  In addition, the Centers for Medicare & Medicaid Services (CMS) also suspended a number of providers using its suspension authority as provided in the Affordable Care Act.  This coordinated takedown is the largest in Strike Force history, both in terms of the number of defendants charged and loss amount.    Attorney General Lynch and Secretary Burwell were joined in the announcement by FBI Director James B. Comey, Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, Inspector General Daniel R. Levinson of the HHS Office of Inspector General (HHS-OIG) and Deputy Administrator and Director of CMS Center for Program Integrity Shantanu Agrawal, M.D.

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Other Actions

• Florida Physician Agrees to Pay $4 Million and To Accept a 5-Year Exclusion From Medicare to Resolve False Claims Act Allegations (June 17, 2015; U.S. Attorney; Southern District of Florida) http://go.usa.gov/3XpzY
• Manhattan U.S. Attorney Settles Civil Fraud Claims Against Inspire Pharmaceuticals, Inc. For Its Misleading Marketing Designed To Cause Prescriptions Of Azasite For Non-Fda Approved Uses (June 17, 2015; U.S. Attorney; Southern District of New York) http://go.usa.gov/3XpzY
• Former Shelby County Hospital CFO Sentenced in EHR Incentive Case (June 17, 2015; U.S. Attorney; Eastern District of Texas) http://go.usa.gov/3XpzY
• Registered Nurse Co-Owner of Ultimate Care Home Health Services, Inc. Pleads Guilty to Role in Healthcare Fraud Conspiracy (June 16, 2015; U.S. Attorney; Northern District of Texas) http://go.usa.gov/3XpzY
• State Enforcement Actions Updated http://go.usa.gov/3XpJk

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If we can be of any further assistance, please send an email to public.affairs@oig.hhs.gov . 

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Like GPC Publication onFB

 

• National Coordinator of the Family Survey Program
  When One Deals with the Child Protective AGENCY>>;LearnMore

Fraud Upon the Court - A Few Thoughts

I would take a moment to quote some of the Great Information found on this Blog:
Foster Parents: Did You Know? Information found in this blog are not only useful for Foster Parents, but ALL parents, who are facing the wrath of the Child Protective Agencies.

There are two major topics brought out in this particular post:

1. Are Social Workers Part of the Court?;
2. Questions for you when defending yourself

Are Social Workers Part of the Court?

Consider this statement in the blog:

"In order for an officer of the court to enter your home against your will, be it a social worker or police officer, he or she must have a warrant in their hand when they step through the door. If anyone has evidence that you have committed a crime, that evidence must be presented to a judge, while under oath or affirmation, and the judge must decide whether that evidence contains enough "probable cause" for him or her to issue the warrant. The evidence presented to a judge must indicate that you have committed a crime." Here is the Link.

Questions for you when defending yourself

1. Have you been to court to defend yourself against an allegation?
2. Did you hear lies in that courtroom?
   Question; does our definition fit the persons testifying in your courtroom, did they commit “fraud on the court? Did they give false information to the court, mislead the court? 
3. Did you complete your research, copy of your statutes, investigative report, highlighting the things you disagree with, or that were complete lies or exaggerations?
4. Can you prove these were lies? Then this officer of the court has committed "fraud on the court!"

• If so you may have grounds for an appeal. Did you know you have only thirty days in most states to file an appeal?

Got your attention?  Thought so. Stay with us. Remember, we are not attorneys, just advocates fighting for you.

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Do encourage everyone to visit and/or comment on this blog>> Foster Parents: Did You Know?

Also, as a work in progress, here are some of the earlier blog post topics index on our NFPCAR website:

Topics
07/05/2010
Please Note: On the bottom of each Part, there is a direct link to the "Did You Know Series" on examiner.com

• Families in Danger
  • Empty Nesters (2 Part Series)
• What does removal do to the children? (3 Part Series)
• Inadequate Training ( 4 Part Series)
• Allegations (7 Part Series)

• Guilty Until Proven Innocent?? (3 Part Series)

• Define Child Abuse?? (4 Part Series)
• Documentation "How Important is it?" (5 Part Series)
• Inadequate Training (4 Part Series)
• Administrative Law (5 Part Series)
• What is CAP?  (2 Part Series)
• What is the CPS Hotline?? (3 Part Series)
• CPS vs Slavery (3 Part Series)
• State Child Abuse Registry (2 Part Series)

• What is "In Loco Parentis" (3 Part Series)

• It's ALL about YOU
• One Small Voice (2 Part Series)
• Advocates for YOU or THEMSELVES (4 Part Series)
• The Foster Care System, can it be Salvaged? (12 Part Series)
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  And who is the Author of this blog?:
  Become an examiner
  
  

  Marilyn Harrison

  • Foster Families Examiner

  RSSSubscribe
  Marilyn, the National Administrator for Foster Parents Legal Solutions, business for 12 years, and National Director for NFPCAR one of the most successful support groups on the internet on behalf of Foster/adoptive/and biological parents. Her outstanding articles published in Fostering Families Today magazine, the author of Standing in the Shadow of Law. She offers an unequaled educational facilitation in the field of Administrative Law, Pro Se, handling your own case, or assistance to your attorney. She has assisted thousands of foster parents facing an epidemic of allegations across our Nation. She is not an attorney, but an advocate.
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  Link to Our Affiliation
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  May you find Strength in Your Higher Power,

   GranPa Chuck

    "We the "Little" People"

      Defend Yourself http://nfpcar.org/Jurisdictionary/

    My Family Reform Blog
    My Family Rights Affiliation 
  

Report Medicare Fraud - Voice your Concerns

At the end of 2010 it was Reported That Medicare Fraud was  NOW HIGHER Than Military Fraud
Voice Your Concerns

• Fraud Hotline
• Fraud Tips and Leads
• The Central Registry of Child Welfare Fraud
• Download the Contractor Code of Ethics and Business Conduct Poster (PDF)

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