Tag Archives: Healthcare

U.S. completes ‘takedown’ of Medicare fraud: officials

Attorney General Loretta E. Lynch

By Sarah N. Lynch

WASHINGTON (Reuters) – U.S. law enforcement officials have charged 301 suspects with trying to defraud Medicare and other federal insurance programs in 2016, marking the “largest takedown” involving health care fraud allegations, the Justice Department said on Wednesday.

The national sweep resulted in charges against doctors, nurses, pharmacists and physical therapists accused of fraud that cost the government $900 million, the department said.

The cases involved an array of charges, including conspiracy to commit health care fraud, money laundering and violations of an anti-kickback law.

This year’s sweep exceeded last year’s record in which 243 defendants faced charges in a combined $712 million in government losses. Officials said it was the largest takedown in the nine-year history of the Medicare Fraud Strike Force, a joint initiative between federal, state and local law enforcement.

Attorney General Loretta Lynch said some of the cases reflect new, troublesome trends, including instances of identity theft in order to prepare fake prescriptions and a growing number of cases involving compounding, or the mixing of medications tailored to meet a patient’s needs.

Compounded medications are typically very expensive. From 2012 to 2014, the quarterly Medicare spending on these prescriptions skyrocketed from $28 million to $171 million.

“As this takedown should make clear, health care fraud is not an abstract violation or benign offense,” Lynch said. “It is a serious crime.”

In one case, two owners of a group of outpatient clinics and a patient recruiter stand accused of filing $36 million in fraudulent claims for physical therapy and other services that were not medically necessary.

The Justice Department said that to find patients, the clinic operators and the recruiter targeted poor drug addicts and offered them narcotics so they could bill them for services that were never provided.

Another case was filed against the operator of a marketing business that received referral fees from pharmacies that filled and billed Tricare, the U.S. military’s government insurance program, for compounded medicines.

The prescriptions were submitted via “telemedicine” sites, and doctors were given blank prescription forms to fill out, regardless of medical necessity, according to the complaint.

One doctor told the FBI her identity and medical credentials were used without her permission to fill thousands of dollars worth of prescriptions.

drcolbert.monthly

Supreme Court Upholds ACA Subsidies

The Supreme Court has upheld by a 6-3 decision a key provision of President Obama’s signature healthcare law by saying that tax subsidies are Constitutional even though the law does not specifically say that federal subsidies can be issued in states with no state healthcare exchanges.

“After more than 50 votes in Congress to repeal or weaken this law, after a presidential election based in part on preserving or repealing this law, after multiple challenges to this law before the Supreme Court, the Affordable Care Act is here to stay,” Obama said in the White House Rose Garden.

“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” Roberts wrote in the court’s decision, adding that nationwide availability of the credits is required to “avoid the type of calamitous result that Congress plainly meant to avoid.”

“In this instance,” he wrote, “the context and structure of the act compel us to depart from what would otherwise be the most natural reading of the pertinent statutory phrase.”

The decision was the second time in three years that the Supreme Court has ruled against major challenges to the Affordable Care Act.

Justice Antonin Scalia said: “We really should start calling the law SCOTUScare,” Scalia said. SCOTUS is the acronym for the Supreme Court of the United States. “This court has no free-floating power to rescue Congress from its drafting mistakes.”

Nepal Quake Devastated Nation’s Healthcare System

The massive 7.8 earthquake that rocked Nepal and left hundreds dead still hasn’t been fully noted by the government but a report on the state of the healthcare system shows the country is in serious trouble.

A new report given to the Nepal planning commission shows that one third of the nation’s healthcare system has been destroyed or severely damaged to the point it is currently inoperable.  Almost 450 public health facilities in the nation were completely destroyed by the quake and its aftershocks.

Over 700 public health facilities have been reported with significant damage although they are still able to provide some services.

The total value of the damage is estimated to be around $58 million and the estimate cost to rebuild is close to $110 million over the next five years.

The situation is being complicated by the monsoon season with landslides threatening some of the remaining damaged healthcare structures.

The WHO said Nepal was one of the worst nations in the world for healthcare before the quake, with only 2.1 doctors per 10,000 residents of the population.    The WHO says native doctors head for more industrialized nations in search of better pay and working conditions.

“Health services must be rebuilt and made accessible to all, while risk-reduction programmes must be implemented at the sub-national level,” Poonam Khetrapal Singh, the WHO regional director for Southeast Asia, wrote last week. “Soil testing, the enforcement of health facility-related building codes, and investment in design of quake-proof facilities and homes must be encouraged across the country.”

Michigan House Approves Religious Freedom Restoration Act

The Michigan House of Representatives has passed a state version of the federal Religious Freedom Restoration Act despite outcry from anti-Christian groups in the state.

The bill, HB5958, cleared the House Judiciary Committee 7-4 and passed the full House 59-50.  The Senate now picks up the bill for consideration.

The bill was introduced in the state house because the federal law, signed into law in 1993 by President Bill Clinton, only applies to federal issues.  Legislators in Michigan wanted to make sure Christians and other people of faith had their rights protected from state groups and organizations.

The statute reads: “The free exercise of religion is an inherent, fundamental, and unalienable right secured by Article 1 of the state Constitution of 1963 and the First Amendment to the United States Constitution.”

The bill is in response to anti-Christian groups that want to eliminate Christians and people of faith from being able to exercise their rights in society.

“I support individual liberty and I support religious freedom,” House Speaker Jase Bolger (R) declared Thursday to the Judiciary Committee. “I have been horrified as some have claimed that a person’s faith should only be practiced while hiding in their home or in their church.”

District of Columbia Delays Abortion Coverage Vote

A bill to force all business owners in the District of Columbia to provide abortion coverage to employees regardless of their faith beliefs has been delayed.

The “Reproductive Health Non-Discrimination Amendment Act of 2014” was pulled on Tuesday afternoon.  The bill was introduced in the wake of the Hobby Lobby Supreme Court decision that said the government could not force business owners to pay for abortion coverage.

“The council seems to have heard the voices warning them not to waste D.C. taxpayer dollars promoting the abortion lobby’s interests,” said Casey Mattox of the Alliance Defending Freedom.  “There is simply no prospect that a court would uphold a bill forcing D.C. prolife non-profits to pay for abortions. The D.C. Council has wisely stepped back from the ledge and – for now – respected fundamental freedoms and avoided raiding taxpayers’ paychecks.”

Pro-abortion organizations had hailed the bill and the infringement on the religious freedom of business owners to advance abortion including NARAL Pro-Choice America.

Pro-life groups contacted the members of the city government to inform them that the bill would be a violation of the Religious Freedom Restoration Act.

Website Reveals Insurance Plans With Abortion Slush Funds

A new website has been launched by two pro-life groups that will allow consumers to find out if the health care plans they are buying actually include charges which will pay for abortions.

The Family Research Council and the Charlotte Lozier Institute announced the launch of ObamacareAbortion.com at a Thursday press event on Capitol Hill.  Representative Chris Smith of New Jersey spoke at the event and condemned the federal healthcare exchange for not providing the information.

“Once again, health consumers are almost clueless as to which plans fund abortion on demand and which do not,” Smith said. “That is why ObamacareAbortion.com is an extraordinarily useful new tool for healthcare consumers. … The Obama administration’s cover-up of abortion insurance plans on the exchange is unnecessary, unacceptable and absolutely unconscionable.  Consumers have the right to know. Abortion is not healthcare. It dismembers and chemically poisons defenseless unborn children and hurts women.”

The research from the ground found that in nine states that 90 percent of the health care plans cover abortions.  Until last week, Connecticut had no plans that did not include abortion in some way.

“It is virtually impossible to know what your plan entails in other states,” said Kerri Kupec of Alliance Defending Freedom to The Christian Post. “Even if you are not living in these four states, you could very well be living in another state that includes these surcharges and you don’t even know about it. That is why the work of Family Research Council and Charlotte Lozier Institute is absolutely crucial to taking down this web of secrecy.”