I don't doubt a word you say, but I have never had a doctor get what Medicare
owed them. I know a lot of people think Dr.s should be paid the same as
barbers. My doctors have also employed relatives. Why not? Nepotism is a
problem in police forces and government, not a doctors office. My doctor
charges $80 per visit and Medicare pays him $42. My podiatrist will get $66.
The vet gets $65. The insurance company flips a coin and if the doctor wins, he
gets the coin.
Medicare fraud to me is when I am told I'll soon be using a Pride Jazzy. My
Waiver representative is an atheist so to save gas she calls me each month to
see if I'm alive and have I started jogging yet? A usual litany of questions
regarding each others lives and g'bye. On occasions I have had bad doctors. A
urologist in fact. I did report him to Medicare, but I'm sure he still
practices medicine.
I would not expect the doctor to set up more appointments if I just accused him
of fraud! This accusation is a doctor/patient relationship killer. Some Doctors
are so good they do make millions. I do not resent a single dollar. If you
accuse the medical system of malpractice and fraud very often, you will start
having trouble seeing doctors that are not in an Emergency Room. You won't
find anyone that wants to work for while you accuse them of federal crimes.
Your name will get around and you will be going to Dr's that only see Medicare
cases.
I've seen doctors submit very large bills to Medicare that I thought were a
little steep. This guy is 44 years old and still paying student loans from hell
while trying to raise a family and after the insurance company is allowed to
price fix against doctors, Medicare undercuts him by 70% and the rest are too
poor to even send an X-mas card, then he has to buy malpractice insurance that
costs him so much that many really good doctors only work for drug companies.
Now, just to show how stupid they can be, congress has decided it will cut any
doctor bills by 10 percent. Why not cut what tort lawyers get by ten percent.
Cut the amount lawyers get from Medicare by 10 percent and save big money. Cut
back all payments from the US government to lawyers until the budget is
balanced! We will have a balanced budget in 6 months.
Treating Doctors as if they cause health care problems is the DUMBEST thing
congress has done since passing the Patriot Act, and ranks with the meanest
thing since forcing Japanese Americans into intern camps. Why not force Oil
corporations to cut prices by 10 percent? Because of their honesty?
We have found the line between good and evil and made a mad dash to the wrong
freakin side again!
john
----- Original Message ----
From: Lori Michaelson <[EMAIL PROTECTED]>
To: quad-list@eskimo.com
Sent: Monday, June 30, 2008 8:18:07 PM
Subject: [QUAD-L] Medicare fraud is blatant but is not being stopped
Todd ... here I will get to what I found out is happening more and more AND in
one doctor's office in particular (further below my first-hand experience which
I talk about first) regarding Medicare fraud or theft. Same difference.
I know long e-mails are laborious to read but I hope that many of you DO read
this for yourself, for your parents, for your grandparents or whomever who will
probably, in some way and some time, fall into these traps.
FIRST THOUGH -- Here is one of my first-hand case scenarios with a doctor's
offices getting away with double dipping Medicare and getting away with it.
I had a primary care physician here four years ago. My husband was also a
patient of his. Had him abt 2 yrs. Neither of us go to the doctor's office
that much but it does not even have to take that to let me/us see what is going
on. Whenever I DID go ... I would receive their bill and what they billed
Medicare for. And then I would have to wait for CMS's Medicare's Explanation
of Benefits to see what my responsibility of the bill was.
Well, the last bill I received from this particular doctor (for a visit of
mine) was so screwy you could not even read what was what. My husband called
and asked for a bill that was more itemized and readable. They disagreed that
there was anything wrong with their billing statement. Heanen forbid! My
husband called because he is better at dealing with people... especially those
that are trying to lie to your face. The other problem we saw was that the
bill was SO VERY screwy but it was also set up to be able to double dip in
getting Medicare payments. In other words... getting paid twice by Medicare.
I get a tiny bit of help from a home health agency paid for 100% by MediCARE.
I'm getting robbed of over 98% of what I am eligible for but that is an
entirely different story. Anyway, every 65 days I have to be recertified to
make sure that I am still a quadriplegic (ha ha - ho -ho)and still in need of
home health help. The home health agency sends my physician a sheet of paper
for him to sign and date that I am still in need of services every 2 months for
this recertification. And that is ALL a physician has to do... sign one and
date one. Every 65 days.
MEDICARE, for approximately the last six years now, has allowed physicians to
bill Medicare for their signatures!!! And it is not just a small amount. It
is close to $200 or more! Absolutely crazy! But that's the federal government
for you! But it gets worse.
What is so ironic is that Medicare has a fraud hotline. But it is a joke.
They are also federal government employees and nothing gets done even if it is
reported. Anyway, when we noticed on the bill that my doctor's office was
billing Medicare twice for my 65 day recertifications over a 9 month period ...
I again asked for an itemized, readable bill. The bill was a mess but that was
to throw off Medicare fraud being perpetrated by doing this. When my husband
asked why their office was billing Medicare twice -- they had a fit to be
called on it. No surprise there. And then the billing clerk accused my
husband of accusing them of Medicare fraud. Which he never did. I might as
well say here that... guess who we found out his billing clerk was (later via
the receptionist)??? HIS MOMMY!!!
GET THIS - by this last action of ours (questioning the bill) - it was not a
week later where we got a letter from the physician's office saying that we
"had breached the patient/doctor relationship" and that we needed to get new
doctors within two weeks! DUMPING BOTH OF US because of questioning their
billing! This is the honest to God's truth and, since then, I have found out
that this type of of thing is running rampant. I will tell you how I found out
next.
OK ... NEXT ... :-)
Approximately 2 months ago when my home health nurse was here to change my
catheter... we began talking about Medicare fraud and I told her what happened
to us four years ago. She was not surprised in the least.
First of all, MOST MediCARE recipients and patients are people over the age of
65. And it is the elderly who are the meek and never question anything for
fear of losing what they have. Or they are usually easily more conned by these
Medicare Dr. con artists. They trust their doctors, the billing, and just pay
their bills.
So here is what I nurse told me:
She told me this was not the first story she heard of such events. IN FACT she
told me that what happened to me (inquiring about their bill and then being
told that they had breached the patient-doctor relationship and to have to find
new doctors) had just happened to one of her other patients ON MEDICARE. An
elderly person.
But she told me one MORE thing that was very disturbing to both her, and then
after telling me, very disturbing to me. Because of one of her patient's
experiences she found out that there is DEFINITELY one doctor's practice here
in town that ONLY accepts Medicare patients. Hmmmm... wonder why? Obviously,
most of the patients are over 65 and don't question bills. Padding their
pockets nicely.
My nurse told me that she had been familiar with this particular doctor's
office [of probably three physicians] and would never have suspected that they
would be doing what happened to her patient of theirs like another practice did
to me.
People can complain until they are on their deathbed. I have been calling
about Medicare discrimination and fraud and all one gets is the run-around.
Doctors have become wolves in sheep's clothing and getting richer and richer
and richer off the disabled and elderly ON MEDICARE.
Last August, an emergency room doctor's office tried to get away with pretty
much the same thing by FIRT billing me directly and not Medicare! Which is
always the protocol - billing Medicare first. The office clerk tried to tell
me that I was responsible for the bill and other garbagebut I was not going to
buy it/fall for it. Much later I did get a CMS statement and he billed
Medicare for two different things!
The bill that was sent to me was $128. When I told them I was not responsible
for that full payment and they had to go Medicare (which they already know but
are trying to pull the wool over people's eyes with any story) she backed off.
THEN I saw that he had billed Medicare for $368 for one thing and a smaller
amount for another thing.
So doctors, hospitals, clinics, etc. are definitely getting paid more by the
Federal Medicare program but it is the feds to set it up that way to begin
with! I was flabbergasted when I found out that they started allowing
physicians to bill them a hefty amount for just a signature and a date.
Lori
--
Lori
C4/5 complete quad, 28 years post
Tucson, AZ
