Medicare to cap payments amid rampant fraud

[babylonsister]

Medicare to cap payments amid rampant fraud

Medicare is proposing a nationwide cut in payments to home healthcare agencies, citing hundreds of millions of dollars in fraudulent claims, primarily for Miami-Dade diabetics.


BY JAY WEAVER
[email protected]


Fueled by massive fraud, home healthcare providers in Miami-Dade County are raking in more Medicare money than their colleagues in the rest of the country combined -- thanks to bogus billings for patients with diabetes, authorities say.

Now, Medicare is taking tough steps to stop agencies from filing hundreds of millions of dollars a year in false claims.

The federal agency is proposing a nationwide cap that would reduce Medicare reimbursements to any agency treating homebound patients with diabetes or other chronic ailments. The proposed limit: 10 percent of the bill.

Though national in scope, Medicare's plan is really aimed at shutting down hundreds of home healthcare agencies in Miami-Dade suspected of submitting phony claims for twice-daily insulin injections by a visiting nurse, officials said.

``We looked at {Miami-Dade} as an albatross because it was weighing us all down,'' said William Dombi, a vice president at the National Association for Home Care and Hospice, a Washington trade group that pitched the 10 percent cap to Congress. ``It's beyond an embarrassment -- it's harmful to everyone across the country.''

Miami-Dade's reputation for Medicare fraud in general, and excessive home care billing in particular, has deeply troubled lawmakers weighing the Obama administration's efforts to expand health coverage for millions of uninsured Americans.

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http://www.miamiherald.com/460/story/1171663.html

[DainBramaged]

1. Stop slapping these scumbag on the wrist and JAIL them for long periods of time

ASAP not in two or three years with prosecutors allowing them to plead out to minor offenses with fines.

[Xipe Totec]

2. I have a better idea

How about paying 100% for legitimate claims, and 0% for fraudulent ones?

And how about prosecuting those who submit fraudulent claims?

[MADem]

3. I will also weigh in with a recommendation for jail time for cheats. That should stop this shit. nt

[DrDan]

4. an auditor would probably cost $100,000K - and probably save medicare millions

yet how do we trim the costs? We eliminate the overhead of auditors. Just the opposite of what we should do. To save costs, we should add more.