Friday, July 11, 2014

WDT: For You or I, It's a Crime....For Others Just a "Mistake"

   "Mistakes".....Unless you or I did it, then it's a crime.  Who was responsible for the double billing of Medicare ?  And is it true this is all fairly common in health care and that's why it's considered not a big deal ?
     I think it's stealing.  It would be if I swiped a candy bar at Tiny's.....I could tell the cops it was just a mistake and everything would be OK.
Watertown Daily Times | Carthage hospital settles Medicare fraud suit, will repay $750k


Anonymous said...

Didn't the County of Jefferson give them 3million for a Nursing home? Same with SMC that's the crime.

Anonymous said...

What are you talking about? It sounds like a mistake and that is how it was treated. Don't forget that they almost went belly up because Obamacare forced them to implement a new Obamacare payment software, which didn't work. Probably this new software was involved in the mistake.

Now if they had actually just put the checks in the desk draw and screwed off all day like Parks and Rec did then it would be a mistake in your eyes.

L.A. Moore said...

Such as Johnny D's parking on the grass off Washington St on Tuesday. If you or I were to park there, we'd be ticketed and towed.

Anonymous said...

Mr. Mayor,
This is not a typical or common in the big picture of medical billing. This is a problem that was caused by too many consultants who didn't know or care what the ultimate outcome would be being hired, instead of people who know what they are doing and you can actually hold accountable.
Most medical facilities are so heavily regulated that the last thing they want to do is make a mistake that will put them on the radar screen of AG, Medicare/Medicaid, insurance companies, etc. Unfortunately, the same medical facilities spend way too much on the salary of the CEO, CFO etc. and then can't afford to hire/retain great people to actually do the work and so they hire the $10/hour girl who couldn't care less about the outcome and is just waiting for Friday to collect her pay check.
The more interesting question I would ask about this piece is considering CAH had already admitted their mistake and made arrangements for the pay back, why is this news now and who benefits? SMC needs to show the north country that they are the only facility capable of....and therefore the leader who will take over all health care in the north country, for our own good don't you know.
When all competition is eliminated is it really cooperation or forced affiliation?

Anonymous said...

8:22 you are right. Probably softening up the public for some kind of take-over.

I found this link where they had to have three consultants take over implementing their electronic billing after a bunch of people left:

What they didn't say is that the electr4onic billing was mandated by Obamacare but never worked. Instead they said it was implemented to get 3 million in stimulus money.

So if there is any malfeasance here it would be those consultants. But since the only one that "gained" anything was a non profit hospital, it is a safe bet it was just incompetence on the part of those consultants, not done on purpose.

Anonymous said...

Talk about double-standard: If you or I did it, it would be a crime... Syracuse, lady leaves a bar followed by her off-duty Sheriff's Investigator friend. She hits a pedestrian and kills him. The cop continues to follow her home like nothing happened. DA says the off-duty cop had no obligation to do anything.


Anonymous said...

Yeah you try shoplifting at Tiny's and you may end up sleeping with the fishes.Or at least getting your hand whacked with a sauce spoon!

Anonymous said...

True story about gov't health-care billing.

My son required a specialist not available at XYZ AFB. CHAMPUS sent him to the office of 'Laurel & Hardy', experts for the condition he had.

Dr. Hardy was not available being on vacation. Doctor Laurel treated my child and was paid by the taxpayer via CHAMPUS.

Several weeks later Dr. Hardy submitted a bill, an exact copy of Dr. Laurel's bill. He flat-out said he was "entitled" to this fee since he & Laurel shared the same office.

I was harshly punished for initially refusing to sign the payment authorization. I thought this fraud then & I still do 30+ years later.

But Hardy was a personal friend of the AFB commander and he got his taxpayer's money

for a patient he never met (and would never meet) because he was on vacation

& I was beat about the head & shoulders for questioning the validity of such an arrangement.

This is when I first learned the American taxpayer was nothing more than a slush-fund for the connected.

Anonymous said...

In an era where Obumba can hide his IRS crimes by losing emails, why shouldn't anybody be able to make a mistake?

Anonymous said...

Anyone who doesn’t think CAH is not guilty of intentional fraudulent practices better think again. My elderly father was hospitalized there in 2007 toward the end of his life for approximately two months. While there his Medicare Insurance was overbilled to the tune of $20,000. Our family didn’t discover it until months later after he passed. I brought it to the hospitals administration attention and it fell on deaf ears as I was summarily ignored. I decided to contact Medicare and again it fell on deaf ears. I got the distinct impression that this was a deliberate and ongoing policy with the hospital as I am also aware of other people who were victimized by this practice. A $750,000 fine is getting off easy when there should be criminal indictments.