Medicare Fraud Uncovered

For FREE help finding a Medicare plan,
Click here or call 1-800-729-9590.

As the Administration hopes to save $25 billion dollars in 10 years by going after the waste, abuse and fraud in Medicare, criminals could easy have stolen a trillion dollars during the same period.

Medicare Fraud Uncovered

 

Share This:

21 thoughts on “Medicare Fraud Uncovered

  1. Let’s not forget the $163M stolen from the US TAXPAYER by the Armenians via just one of their many illegal scams (in this case, Medicare fraud)!!

  2. What about Medicare’s new NON EMERGENCY Ambulance transportation Prior Authorization punishment Program that is bankrupting the private ambulance companies in New Jersey , South Carolina and Pennsylvania? Clearly we have followed the rules and was never investigated. My company provides both emergency and non emergency transportation services with only 4 Bed bound dialysis patients and no matter the proof of medical documentation we provided to the company sub contracted with medicare to either affirm or non affirm. They non affirmed aka DENIED every one of our 4 patients. If hospital records read a patient is debilitated , bed bound with stage 4 pressure ulcers on the buttocks and the patient requires continuous oxygen inaddition has 24/ 7 nursing care. The documentation wasnt sufficient because the doctors failed to note why in the hospital records! First: We have no control of doctors vocabulary. If the notes read what I listed above. The documentation we provided is more then enough to justify payment. Im honestly considering filing judgment against the 3rd party prior authorization company and to include Medicare for a deliberate tactic their using to recoup monies from companies who fraudulently billed medicare when patients could’ve traveled by other means of transportation like a car, taxi or wheelchair van. All 3 modes are not covered. We haven’t been paid since December 2014 and it’s drained my soul and my bank account.
    Thank god we only have 4 non emergency dialysis patients. Its the principal at this point of the game. Its delibrate and I’m not going to stand for it much longer. All calls were recorded with the authorization company which clearly an idiot can hear and figure out the obvious. They have something to gain with Medicare and Its delibrate and disgraceful on Medicare’s part. Over 200 companies closed in all 3 States since December 2014 and yes. some were guilty of fraud. Its to bad no investigators pounced the pavement to catch the bad ones. What about the rest of us with spotless billing records? We proved our patients the service and they met medical necessity without a reasonable doubt! 2 weeks ago we started appealing some claims we sent and they were denied too! Why? Because Medicare appeal department lost ALL the medical documentation but we didn’t know it at the time. The reason. Insufficient documentation! If i didn’t litterly start crying due to the stress this has caused all of us! They passed the buck. They knew i was upset as I demanded they investigate to locate the 84 pages that we scanned and faxed with a receipt of hospital records prooving they received. If i didn’t take these desperate additional steps. They wouldn’t passed the buck and we would then be required go to the next step of the appeal process. I’m not convinced it was incompetence or its just another delibrate tactic on their part to deny payment. As of today, August 19, 2015 not even close to half the claims are pending for payment.
    Quite honestly, these disgraceful tactics during the past 8 and 1/2 months has taken its toll on me. As much as I love providing the best patient care in the United states of America. I feel I can’t go on much longer because they broke me down. I have a smoking gun lawsuit and I’m upset. Especially since I worked so hard to operate a clean agency with over 36 years under my belt. I’m sick over it!
    After listening to some patients saying they called medicare to report pharmaceutical companies fraudulently billing for services not rendered and medicare did nothing. Include us too! For over 5 years i contacted the OIG and left detailed messages countless times. Sadly, no representative ever returned my calls. What they did to us must be criminal and depending on the out come of these few pending claims. Its most likely the bulk of the other claims. All 8 months worth that are ready to send for payment. Im not looking forward for the fight all over again. rest assure. I will fight and then I’ll have no choise other then seek legal council. Its not right!

  3. What about Medicare’s new NON EMERGENCY Ambulance transportation Prior Authorization punishment Program that is bankrupting the private ambulance companies in New Jersey , South Carolina and Pennsylvania? Clearly we have followed the rules and was never investigated. My company provides both emergency and non emergency transportation services with only 4 Bed bound dialysis patients and no matter the proo /f of medical documentation we provided to the company sub contracted with medicare to either affirm or non affirm. They non affirmed aka DENIED every one of our 4 patients. If hospital records read a patient is debilitated , bed bound with stage 4 pressure ulcers on the buttocks and the patient requires continuous oxygen inaddition has 24/ 7 nursing care. The documentation wasnt sufficient because the doctors failed to note why in the hospital records! First: We have no control of doctors vocabulary. If the notes read what I listed above. The documentation we provided is more then enough to justify payment. Im honestly considering filing judgment against the 3rd party prior authorization company and to include Medicare for a deliberate tactic their using to recoup monies from companies who fraudulently billed medicare when patients could’ve traveled by other means of transportation like a car, taxi or wheelchair van. All 3 modes are not covered. We haven’t been paid since December 2014 and it’s drained my soul and my bank account.
    Thank god we only have 4 non emergency dialysis patients. Its the principal at this point of the game. Its delibrate and I’m not going to stand for it much longer. All calls were recorded with the authorization company which clearly an idiot can hear and figure out the obvious. They have something to gain with Medicare and Its delibrate and disgraceful on Medicare’s part. Over 200 companies closed in all 3 States since December 2014 and yes. some were guilty of fraud. Its to bad no investigators pounced the pavement to catch the bad ones. What about the rest of us with spotless billing records? We proved our patients the service and they met medical necessity without a reasonable doubt! 2 weeks ago we started appealing some claims we sent and they were denied too! Why? Because Medicare appeal department lost ALL the medical documentation but we didn’t know it at the time. The reason. Insufficient documentation! If i didn’t litterly start crying due to the stress this has caused all of us! They passed the buck. They knew i was upset as I demanded they investigate to locate the 84 pages that we scanned and faxed with a receipt of hospital records prooving they received. If i didn’t take these desperate additional steps. They wouldn’t passed the buck and we would then be required go to the next step of the appeal process. I’m not convinced it was incompetence or its just another delibrate tactic on their part to deny payment. As of today, August 19, 2015 not even close to half the claims are pending for payment.
    Quite honestly, these disgraceful tactics during the past 8 and 1/2 months has taken its toll on me. As much as I love providing the best patient care in the United states of America. I feel I can’t go on much longer because they broke me down. I have a smoking gun lawsuit and I’m upset. Especially since I worked so hard to operate a clean agency with over 36 years under my belt. I’m sick over it!
    After listening to some patients saying they called medicare to report pharmaceutical companies fraudulently billing for services not rendered and medicare did nothing. Include us too! For over 5 years i contacted the OIG and left detailed messages countless times. Sadly, no representative ever returned my calls. What they did to us must be criminal and depending on the out come of these few pending claims. Its most likely the bulk of the other claims. All 8 months worth that are ready to send for payment. Im not looking forward for the fight all over again. rest assure. I will fight and then I’ll have no choise other then seek legal council. Its not right!

  4. What about Medicare’s new NON EMERGENCY Ambulance transportation Prior Authorization punishment Program that is bankrupting the private ambulance companies in New Jersey , South Carolina and Pennsylvania? Clearly we have followed the rules and was never investigated. My company provides both emergency and non emergency transportation services with only 4 Bed bound dialysis patients and no matter the proo /f of medical documentation we provided to the company sub contracted with medicare to either affirm or non affirm. They non affirmed aka DENIED every one of our 4 patients. If hospital records read a patient is debilitated , bed bound with stage 4 pressure ulcers on the buttocks and the patient requires continuous oxygen inaddition has 24/ 7 nursing care. The documentation wasnt sufficient because the doctors failed to note why in the hospital records! First: We have no control of doctors vocabulary. If the notes read what I listed above. The documentation we provided is more then enough to justify payment. Im honestly considering filing judgment against the 3rd party prior authorization company and to include Medicare for a deliberate tactic their using to recoup monies from companies who fraudulently billed medicare when patients could’ve traveled by other means of transportation like a car, taxi or wheelchair van. All 3 modes are not covered. We haven’t been paid since December 2014 and it’s drained my soul and my bank account.
    Thank god we only have 4 non emergency dialysis patients. Its the principal at this point of the game. Its delibrate and I’m not going to stand for it much longer. All calls were recorded with the authorization company which clearly an idiot can hear and figure out the obvious. They have something to gain with Medicare and Its delibrate and disgraceful on Medicare’s part. Over 200 companies closed in all 3 States since December 2014 and yes. some were guilty of fraud. Its to bad no investigators pounced the pavement to catch the bad ones. What about the rest of us with spotless billing records? We proved our patients the service and they met medical necessity without a reasonable doubt! 2 weeks ago we started appealing some claims we sent and they were denied too! Why? Because Medicare appeal department lost ALL the medical documentation but we didn’t know it at the time. The reason. Insufficient documentation! If i didn’t litterly start crying due to the stress this has caused all of us! They passed the buck. They knew i was upset as I demanded they investigate to locate the 84 pages that we scanned and faxed with a receipt of hospital records prooving they received. If i didn’t take these desperate additional steps. They wouldn’t passed the buck and we would then be required go to the next step of the appeal process. I’m not convinced it was incompetence or its just another delibrate tactic on their part to deny payment. As of today, August 19, 2015 not even close to half the claims are pending for payment.
    Quite honestly, these disgraceful tactics during the past 8 and 1/2 months has taken its toll on me. As much as I love providing the best patient care in the United states of America. I feel I can’t go on much longer because they broke me down. I have a smoking gun lawsuit and I’m upset. Especially since I worked so hard to operate a clean agency with over 36 years under my belt. I’m sick over it!
    After listening to some patients saying they called medicare to report pharmaceutical companies fraudulently billing for services not rendered and medicare did nothing. Include us too! For over 5 years i contacted the OIG and left detailed messages countless times. Sadly, no representative ever returned my calls. What they did to us must be criminal and depending on the out come of these few pending claims. Its most likely the bulk of the other claims. All 8 months worth that are ready to send for payment. Im not looking forward for the fight all over again. rest assure. I will fight and then I’ll have no choise other then seek legal council. Its not right!

  5. Biggest medicare Fraud is the Dialysis industry taking 40 billion/year of our tax payer money for a treatment that does not really replace the Kidney’s or is a scheme where they need new patients to keep their scheme going.

    • That is true , for a doctor who gets paid for a one monthly appointment of $ 600  he just walks by writes down some numbers off a machine and walks to the next chair and does the same thing , times that by 15 chairs off 3  shifts  equals to $ 27,000 a month  for not even asking the patient  one question  and bills Medicare  another $ 4000 a treatment .   The company owns the machines and saline and is a franchise  managed by the doctor .

  6. perhaps we could farm them out to prisons in the far east as a way to save money. Or, with so many surplus ships in mothballs, they could be loaded aboard and mistaken for a target vessel being used for torpedo practice.

  7. I went to a local Hospital at 3am in the morning for stomach problems. I drove myself to the ER section at the Hospital. I stayed about 2 hours in a single room, has my vitals taken, and had a Cat Scan. The Doctor later poked his head into the room I was in from the hallway and said everything looked good, and I was released. I got my bill about 3 weeks later. Medicare was billed 10,506.02 by the Hospital. The Doctor who poked his head in my room billed Medicare 925.00. And Radiology Associates who did the Cat Scan billed Medicare 357.00. Almost 12,000 dollars for being at the Hospital for 2 hours. To me this is also fraud.

    • RichardButch
      Well Medicare most likely paid the hospital 3-4 thousand if that much and the rest was a write off, the doctor was probably paid 2-3 hundred dollars, if that, and the rest was a write off, the radiologist probably $70-107 dollars for the X-ray, the billed amount means nothing when you accept Medicare’s assignment because most of the billed amount is written off and that’s the same with any insurance company that has a contract with the medical provider, the doctor can bill $750,000.00 for an office visit but if Medicare only allows $100.00 the doctor has to write off $749,900.00 and the patient can’t be billed for it nor is Medicare going to allow or pay anything more on it.

  8. well at least stop auto adjudicating prescription drug claims, wouldn’t it cost less to have a claims unit reviewing and investigating claims, and can’t they make a law to penalize business owners with a Medicare PIN that don’t notify Medicare the business is changing owners so that they can discontinue that provider identification number and the new owners need to register for a new provider identification number before getting payment, it’s not that hard to stop a good portion of the fraudulent claims.

  9. I have Medicare and my doctor wants me to come to the office every month but I only want to come twice a year. So the doctor dumps me because he doesn’t make enough money from me. Sick.

  10. Until the government can keep people from stealing my money through social programs, the programs should be friggin cancelled.

  11. It should be absolutely mandatory for medical organizations that provide Medicare and Medicare services to make their medicare and medicaid billing available to patients. Since 2016 I’m member of Medicare and Kaiser is providing me with medicare services. For the last 3 years I’m in dispute with Kaiser because they REFUSE to provide me with the access to billing information for the services (doctor visits, blood tests, mammograms etc) that they have provided me with. Who do I need to complain to get access to billing? I’m writing numerous complains and they simply ignore me.

  12. Fraud in Florida?…really???…lmao…yep,that’s right.especially south florida,one of the most corrupted place in the all u.s!

Leave a Reply

Your email address will not be published. Required fields are marked *