Remember the old joke about the lawyer standing at the pearly gates? He says he’s 52. St. Peter answers, “That’s strange. According to your time records, you’re 89.” Apparently, home health provider Doris Betts, of Kansas City, Kansas, hadn’t heard the joke—or didn’t get it. So when the …
U.S. Accuses NYC of Massive Fraud in Program for Developmentally Challenged Toddlers
October 28, 2014 Leave a Comment
It’s the city that never sleeps. So when it does something, it can do it in a big way. That applies to Medicaid fraud, according to a suit filed yesterday by the U.S. Attorney for the Southern District of New York. The city also has a tough-as-nails reputation. So maybe we shouldn’t be too surprised …
Hospital’s Extortion & Fraud Too Quick to Violate RICO
October 16, 2014 Leave a Comment
If a hospital’s extortion and wire fraud activity is brief enough, it can avoid RICO prosecution. That’s one lesson in an October 2 decision by the federal court for the district of Idaho. Danielle Bennion and her co-plaintiffs filed a RICO (Racketeer Influenced & Corrupt Practices Act) action …
August Scam-of-the-Month Award
August 21, 2014 Leave a Comment
The month is only two-thirds over, but it’s already clear who wins the August Scam-of-the-Month Award. Cleveland Imaging & Surgical Hospital, in Cleveland, Texas, wins in a walk. It turns out that back in 2011 the hospital sold the right to use its hospital billing codes to free-standing clinics. So …
Unnecessary Surgeries Put Hospital in Three-Front War
August 14, 2014 Leave a Comment
When the government accuses a hospital of committing Medicare fraud by billing for unnecessary surgeries, the hospital has a real problem on its hands. It’s at war with the government, and that’s expensive, as well as nerve-wracking. But unless that battle ends in anything short of a complete victory for …
ANOTHER CMS WEAPON: SENIOR SLEUTH SQUAD
June 18, 2014 Leave a Comment
She’s seventyish, grandmotherly and unassuming. She sits patiently in the waiting area of your hospital or medical office, knitting to while away the time. She couldn’t be any less threatening, right? Wrong. She could be part of yet another weapon in the CMS arsenal: the Senior Medicare Patrol. The …