Tag Archives: fraud in medicine
Branded
This photo is really my brand. In 2009 my rural county hospital dismissed me as a physician because I argued against the daily 18 patient quota that they said that Congress had set us. I said, “I will go argue with Congress.” I was not sure how I would get to Congress or when.
Meanwhile, in Oregon, a group called the Mad as Hell Doctors was readying to hit the road. Two weeks before the Mad as Hell Doctors hit the road to go across the country to give talks about single payer healthcare and to listen to citizens talk about their healthcare experiences, a friend called me.
The friend had gone to the Mad as Hell Doctors’ first program, a practice run in Sequim. It was well attended because the community had a controversy over the word “Hell”. The friend said, “It’s a bunch of older white males. They need a woman. You’re off from work: you should go.”
I researched them and called a friend who is a very experienced agitator. He said, “Do it.” I called them and my father drove me to the Bremerton ferry. I got off the ferry in downtown Seattle and was picked up on a street corner to join the Mad as Hell Doctors. I had never met any of them. That evening I was part of the program.
I was and am mad as hell and often sad, frustrated, appalled and incensed by the healthcare industry in the United States, that leaves people without care and dying in spite of costing each and every one of us twice as much as any other country in the world. And all of the CIVILIZED countries have single payer. Am I saying that the United States is uncivilized? Yes, frankly, I am. We are a country run on greed by corporations currently and I am fighting it.
The Mad as Hell Doctors traveled California in 2010 and I was there for a week of that trip. In 2011 they toured Oregon. We continue to work locally, at the state level and at the national level for single payer healthcare, medicare for all. I think that it will happen and hopefully during my career.
We ended the first trip at Congress and the White House. I sent a postcard to my former employer saying “See? I said I would go to Congress.” We haven’t won the health care battle yet but we will.
Here is a ten minute program that I did in Sequim, WA in (2012) at the American Awakening event: Enjoy. If you want to see WHY we are Mad as Hell, watch “Health, Money and Fear” and the other videos at this site. For more information Physicians for a National Health Care Program is excellent and Health-Care Now! is also excellent.
You can make a difference. Do you know anyone who has lost their house, not gotten care soon enough because they didn’t have insurance or were under insured, or has been harmed or died because they were not able to afford or access care? Gotten sick and lost their job and lost their insurance? You, too, should be Mad as Hell and fight to change this.
Fraud in medicine: Diabetic supplies
There is a subtle ongoing fraud in diabetic supplies for diabetic patients and especially medicare patients.
The fraud is in the paperwork. An order form will arrive for me to sign for Mr. Smith. I read the fine print and it says that all of the supplies on the form will be renewed for Mr. Smith, unless something is crossed out. It lists six supplies: lancets to draw blood, strips for the glucose machine, a new glucometer, a new lancet machine and control solution to check that the machine is working correctly.
This is all good and necessary, right? Maybe.
I call Mr. Smith and say, “What do you need?”
“I just need lancets,” says Mr. Smith. “That’s what I asked the company to refill.” He is wondering why I called, because he only asked for lancets.
I cross everything out but the lancets: because that is where the fraud lies. Mr. Smith only renewed his prescription for the lancets, but the medical supply company knows exactly what interval medicare and the other insurances will pay for all of the supplies. They want me to sign a blanket order and then they will send Mr. Smith a new glucometer every time medicare allows, whether he wants and needs it or not. So if you have visited a parent or family member and wondered why they have a closet or a drawer full of some medical equipment, that is why. The doctor did not read the fine print and signed a blanket order and the patient is getting more equipment than they need or want. This is waste and it costs us all money.
Another fraud in diabetic supplies is in getting the first glucometer. I was taught to send the patient to the [diabetic educator] where they would get a “free” glucometer. However, now I tell them to check their local pharmacy instead. The “free” glucometers have the most expensive strips and lancets, and diabetics are supposed to check blood sugar at least once a day. If the strip costs one dollar, that adds up. The pharmacy often has a house brand where the strips and lancets are less expensive. I give the patient the choice. Most of them choose the house brand.
One diabetic equipment company got a hold of one of my patients and wouldn’t let go. They sent paperwork to me saying that they needed every note back to the date that I had prescribed his equipment and copies of his blood sugar records. I wrote them a letter, saying, “I am sending the notes, but I don’t photo copy the patient’s blood sugar records. You are being unreasonable. My notes contain the records I made about his blood sugars.” The company is in Florida and the patient is in Washington. The company kept demanding the notes, all the way back to the first visit, every two months. After we sent them twice, we sent a letter saying, “We already sent those twice. We’re not doing it again.” They continued to fax renewals. I talked to the patient. He wanted them gone too, because they kept calling him and wanting to send him more supplies. I called them. They did not desist. I sent them a letter and tried calling medicare fraud. The medicare fraud department said, “Call the company.” Now we just shred anything they send us, including the threatening notes saying that medicare will be after me.
The diabetic supplies aren’t terribly expensive, but when there are millions of diabetic people, this adds up. Also, most physicians are so busy that they sign papers without reading all that fine print and don’t have time to check what the patient really needs. And the companies are targeting the frail, sick and elderly, though many diabetics are otherwise healthy. I think it is a shameful scam to have a person call a company and say “I need more lancets,” and then to try to send them more of everything. Isn’t that illegal? It should be, to fill prescriptions that have not been renewed. I am tired of seeing more and more clearly how our United States medical system is a system to make money any way possible, and morals don’t matter, and it has nothing to do with people’s health.
http://www.cdc.gov/diabetes/data/statistics/2014statisticsreport.html
29.1 million diabetics in the US
21.0 million diabetics diagnosed in the US
published on everything2 on November 26, 2014 and on Sermo today
Fraud in medicine: oxygen
My father died of emphysema in June of 2013. I found him dead on the floor of his house. I expected this because he was nearly a hermit, but it was still hard.
He was on oxygen. It was prescribed to be continuous.
I started cleaning up the house and trying to find his will. I lined up oxygen tanks and called the oxygen company. There were ten tanks.
The oxygen company picked up the tanks.
I found eight more. I was very busy with a large house, a complicated estate, two years of unpaid taxes, he paid bills on line but had not updated the payments when costs increased……
I hired a local estate sale group. They did an excellent job. The house was sold. I picked up the last few things, including the oxygen tanks.
I called the oxygen company. “Why did my father have 18 oxygen tanks?”
They said, “We delivered them as needed.”
I said, “He didn’t need 18 tanks.”
They said, “They are paid for.”
Oh! Medicare paid for the oxygen. No, not medicare. You and he and I paid for it, because we pay taxes to medicare and medicare pays the oxygen company. Well, 80% and then my father paid the other 20% unless he had a medicare secondary insurance, which he also pays for…. Oh, are you under 65 and thought medicare paid for everything once you got it? Sorry to disillusion you…..My father was supposed to be on oxygen continuously. So the company kept delivering it at the intervals covered by medicare, even though he was not using it all. He sometimes didn’t wear his oxygen and he also had bought his own oxygen concentrator, smaller and easier to move than the one from the oxygen company.
I was furious. “So you kept delivering oxygen even though it was not all being used. And kept charging.”
They said, “We delivered it when it was needed.”
Liars. They delivered more than was needed and I gave some back to them, after medicare had already paid for it.
I still have 8 tanks of oxygen. After all, it’s paid for by medicare, by my taxes and by your taxes. The oxygen is paid for. The tanks belong to the company. I’ll return them when they are empty….. I don’t think the corporation should be able to charge medicare for it twice…..
I should check to see if the company reimbursed medicare and my father for the oxygen when it was returned. If not, I can check into filing a fraud complaint with medicare against the company. But even if they reimbursed medicare and my father’s estate, I am still angry that they kept delivering it when they knew darn well that he had tanks already. Or maybe they don’t even keep track of how many tanks they’ve given out. It’s all about money.
Fight back against corporate greed and fraud. Ask questions. Do not give the oxygen back if it’s been paid for….. give it to someone who needs it instead.
KO Rural Mad As Hell Blog 