Medicaid Provider Fraud

Medicaid provider fraudWhen we get sick, the first thing that we do is ask for professional help, without even admitting that we might become victims of a Medicaid Provider Fraud. Medicaid providers, as a symbol of care and custody, usually inspire trust and confidence, making us expect that our provider will supply us nothing, but help.

Unfortunately, statistics say that Medicaid Provider Fraud is a well-spread phenomenon among scammers, which steal billions of dollars annually. Moreover, the Federal Government also counts on physicians to submit accurate and truthful claims information, by creating such programs as Medicare, Medicaid, and other health care policies. Let’s have a deeper insight into the concept of this type of fraud and analyze the possible countermeasures.

WHO CAN BE CHARGED WITH MEDICAID PROVIDER FRAUD?

First of all, every member of the health care community (individual, corporation, or other entity paid by Medicaid) can potentially become a scammer, including nurses, nurse aides, nursing homes, pharmacies, ambulance and transportation companies, chiropractors, podiatrists, licensed professional counselors, community care service providers, dentists, hospitals, medical equipment companies, speech therapists and others.

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Things You Should Know About Healthcare Programs Recipient Fraud

medicaid fraudEasy money have always been an attractive incentive for the majority of people. Some of us, are more likely to think that a little fraud will not lead to serious cases of criminal prosecution. For those who could not resist temptation – here are several things you should know about Medicaid Recipient Fraud.

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Kermit Gosnell: Accusation Of Illegal Late-term Abortions

A recent Wall Street Journal article written by Peter Loftus and Louise Radnofsky entitled: “Abortion Doctor Convicted of Murder in Baby Deaths”, reports that a Philadelphia abortion doctor was declared to be guilty of first-degree murder in the deaths of three babies born alive.

The hot abortion debate was caused by a horrible case of 2009 when Kermit Gosnell, 72 years old, was convicted of involuntary manslaughter in the 2009 sedation-overdose death of a 41-year-old woman during an abortion procedure. Dr. Gosnell was found not guilty on a third-degree-murder charge in the woman’s death, and he was acquitted of first-degree murder of a fourth baby.

Dr. Gosnell can get the death penalty when the jury will return next week to reach its verdict on his case.

Opponents and supporters of abortion rights have seized on Dr. Gosnell’s case. Antiabortion activists, accusing Dr. Gosnell of the violence in terminating pregnancies, believe the issue of late-term abortions could influence Americans who support abortion rights. They believe there are at least some instances in which abortion should be illegal.

Other opinion accuses restrictive laws in Pennsylvania and many other states, where women with low-income have few possibilities to obtain quality care they need. That is why “inexpensive” Dr. Gosnell became so popular for poor and desperate women, despite his practice could be illegal, unethical and unsafe.

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Find Out if Your Medical Service is Covered By Medicare!

According to the Official U.S. Government Site for Medicare, the Medicare program guarantees health insurance for people ages 65 or older and people under 65 with certain disabilities as well as people of any age with End – Stage Renal Disease (ESRD) (permanent kidney failure that requires a regular course of dialysis or a kidney transplant).

The whole Medicare social insurance program is divided into different parts where each of the part covers specific services:

Medicare Part A applies to Hospital Insurance and covers inpatient care in hospitals and skilled nursing facility, hospice, and home health care.

Medicare Part B applies to Medical Insurance and covers not only doctors’ and other health care providers’ services, outpatient care, durable medical equipment, and home health care, but also some preventive services to help maintain your health and to keep certain illnesses from getting worse (for example, preventive services include Pap tests, flu shots, and screening mammograms).

Medicare Part C, or Medicare Advantage, offers health plan options run by Medicare-approved private insurance companies, helps to get the benefits and services covered under Part A and Part B, and may include extra benefits for an extra cost. Most Medicare Advantage Plans cover Medicare prescription drug coverage (Part D).

Medicare Part C, or Medicare Prescription Drug Coverage, covers the cost of prescription drugs or may help lower your prescription drug costs and help protect against higher costs in the future.

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Health Care Fraud: Sales Force Manipulation

In a recent article written by Bernard Vaughan and Jonathan Stempel entitled: U.S. sues Novartis, alleging kickbacks to pharmacies, Reuters reported that US government accuses Novartis Pharmaceuticals Corp. of paying kickbacks to pharmacies to switch kidney transplant patients from competitors’ drugs to its own and to oppose the use of a cheaper, generic immunosuppressant drug.

Since 2005 at least 20 pharmacies have got illicit payments from Novaris AG, a Swiss drug maker, to push up sales of its immunosuppressant drug Myfortic, said U.S. Attorney Preet Bharara.

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