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re: OT: Corona Panic 2020

Posted on 5/14/20 at 2:43 pm to
Posted by FinleyStreet
Member since Aug 2011
7905 posts
Posted on 5/14/20 at 2:43 pm to
quote:

No doctors and hospitals ever "up-code" their CPT coding to over-charge for a procedure?

The millions upon millions in fraud that get reported each year by Medicare and Insurance companies is just a figment of everyone's imagination?


It's actually pretty hard to commit Medicare fraud. I know it happens, but it's usually with small shops who don't know what they're doing or it involves a whole lot of collusion (i.e. HealthSouth).
Posted by BeefDawg
Atlanta
Member since Sep 2012
4747 posts
Posted on 5/14/20 at 3:09 pm to
quote:

It's actually pretty hard to commit Medicare fraud. I know it happens, but it's usually with small shops who don't know what they're doing or it involves a whole lot of collusion (i.e. HealthSouth).
The FBI and Office of Government Accounting do some report every year, and it's been pretty much the same year over year for a couple decades.

The US spends upwards of $3+ TRILLION on healthcare annually in this country, and there's somewhere between 3-10% attributed to fraud.

That's $90 billion to $300+ billion in fraud.

And Medicare typically has anywhere from $45 billion to $65 billion a year in "improper payments", and they estimate the fraud attributed to this to be anywhere from 50% or more.

So the fact we're in the "BILLIONS" in fraud dollars with regards to healthcare speaks volumes by itself.

Who cares how hard it is to commit Medicare fraud. I'm arguing with a guy who's criticizing me for suggesting some doctors are complicit in padding COVID death numbers, and he's acting like that's blasphemy.

So I hear ya, but come on, man. I'm making sort of a different point.
Posted by SneakyWaff1es
Member since Nov 2012
3944 posts
Posted on 5/14/20 at 3:19 pm to
quote:

It's actually pretty hard to commit Medicare fraud.
No it's not. You can act like you did smoking cessation with a patient when all you really did was say so smoking. Fraudulent as hell and pretty common practice.
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