Archive for the ‘US Health Care’ Category
From the Daily News:
In a bustling black market trade, unscrupulous medical providers are buying Medi-Cal and Medicare patient identity numbers and using them to get reimbursed for millions of dollars in tests and other services that are never provided, authorities say.
Of $34 billion annually spent by the Medi-Cal program for health care for some 7 million poor Californians, state officials estimate that as much as 40 percent or nearly $14 billion is stolen in fraud.
The identity theft scam involves conspirators using stolen patient information purchased for as little as $100. They submit bills for up to $30,000 to cover tests, prescription medicine, wheelchairs and incontinence supplies which are either never delivered or are received and resold on the black market…
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From the NY Post, August 4, 2008:
New York is wasting tens of millions of dollars annually by paying the medical expenses of thousands of former residents who have long since moved out of state, an explosive new audit has found.
The scathing – and still-secret – audit determined that nearly 30,000 people in New York City alone were improperly on the state’s Medicaid rolls from November 2006 to November 2007, even while they were enrolled in the Medicaid programs of other states.
Auditors from state Comptroller Thomas DiNapoli’s office, using federally developed computerized record checks in 44 states, determined that nearly 13,000 of the former city residents “should have been investigated” for violation of New York’s Medicaid regulations, according to the audit, a copy of which was obtained by The Post.
It’s not clear why the other 17,000 out-of-staters were not identified as targets for a probe.
But the city’s Human Resources Administration, which oversees the Medicaid program, investigated only 207 of the cases, the audit says. The results are not known.
The audit concludes that investigations of out-of-state residents improperly receiving Medicaid, as well as efforts to recover the cost of their medical care, are virtually nonexistent.
The audit found that in one year alone, $30 million was spent on Medicaid services for city residents living out of state – in violation of state regulations.
“There are no efforts to recover inappropriate payments,” it says.
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