Hospitals Across The Nation Are Sending Medicare Fraudulent Charges

by comoms | February 14, 2008 at 02:17 pm
366 views | 2 Recommendations | 2 comments

CBS- Robert McCaslin is a man of few words … but many scruples.

"Just the way I'm wired, I guess," he said. "It's just that simple."

Which is why he lost sleep over major taxpayer fraud he unearthed while working in billing at the Houston Hospital District, CBS News investigative correspondent Sharyl Attkisson reports.

"It's an attack on the whole system," he said. "Everybody that pays taxes it involved in this."

McCaslin caught the hospital billing Medicare for accident victims, even if the patient had private insurance that was supposed to pay. The hospital also billed Medicare for prisoners, even though by law, they're not covered.

When McCaslin alerted his bosses, he was surprised to discover they were in on it.

"In one of the meetings with the manager, they said 'that's just the way they did it here.' That was their procedure," he said.

It's not just a problem in Houston. Across the nation, hospitals are sending Medicare improper and fraudulent charges. It's costing taxpayers big time: nearly $11 billion a year.

The government started a pilot program and sent private auditors to comb through hospital bills in three states (California, Florida and New York), looking for Medicare rip-offs.

In one year, they were able to make hospitals pay back an astounding $247.4 million. That's in just three states.

The audits are supposed to expand to all 50 states in March.

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René
René
flagged this story as Good Stuff

at 11:35 on February 15th, 2008

 Hospitals and doctors have been doing this since the early 1960's, and to all insurance companies. The reasoning from our family doctor in the 60s was that 'over-billing' would make sure that insurees would get all their medical bills paid, not just part of it. And this was when a hospital stay was really cheap compared to what it is now!

I figure that this practice has helped drive insurance and medical and hospital and pharmaceutical prices up and up and up! 

comoms, I like this story. It's good stuff.

0
comoms

Great Comment Rene - There is, it seems, a corelation between these underlying problems stemming from  the big Insurance and Pharmeceutical companies.

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