The DOJ Fraud Division, U.S. Attorney’s Office, and Pennsylvania Attorney General today announced criminal charges against 19 defendants, including owners and employees of home care companies, for their alleged participation in various fraud schemes involving over four million dollars in claims to Medicare and Medicaid.
The Pennsylvania Attorney General also announced a plea agreement involving the final defendant in a previously-charged 21 defendant case involving over $1.7 million in claims.
Assistant Attorney General Colin M. McDonald of the Justice Department’s National Fraud Enforcement Division, Dr. Mehmet Oz, Administrator for the Centers for Medicare & Medicaid Services, U.S. Attorney David Metcalf for the Eastern District of Pennsylvania, and senior federal and state officials hold a press conference announcing a significant health care fraud takedown and a new Anti-Fraud Initiative in the Eastern District of Pennsylvania.
To emphasize the scope of the fraud in California and New York Dr Oz notes, “the number one job in the entire state is personal care services.” (WATCH – prompted):
DOJ Press Release – […] The defendants’ conduct was characterized by extraordinary greed. In one case, the Pennsylvania Attorney General charged a purported home health aide who claimed to have provided services to up to seven Medicaid recipients at once. On over 1,100 occasions, the defendant allegedly claimed to have provided care for more than 24 hours in a single day, totaling over 64,000 hours that could not have been worked.
As alleged, Medicaid paid over $1.2 million as a result of the scheme. Another defendant who was charged in today’s announcement, a purported aide, claimed to have worked over 8,700 overlapping hours. As alleged, there were nearly 400 days on which the defendant claimed to be working for more than 24 hours in a day. The defendant allegedly caused over $180,000 in loss to Medicaid. In another case, a defendant was charged who claimed to have provided over 1,300 hours of home care services for a Medicaid recipient who was himself incarcerated on state drug charges. A defendant in one case was captured on a recorded conversation stating that “this home health care is the best kept secret . . . I made a buck plus [each of] the last five years, that’s, that’s a half a million dollars . . . I ain’t checking on nobody.” (read more)
Excellent! Now do election fraud.
Paging judge bo ass burg
We don’t have a national debt problem, we have a national fraud problem.
And it all goes back to tooooo much gvt.
Kudzu strangles everything in it’s path.
But don’t worry, my friends. The elections are secure!
Election integrity is managed by the same government bureaucracy that monitors and approves Medicaid claims. Except every once in awhile they’ll bust a Medicaid fraudster.
We need higher taxes, we’re not keeping pace with the fraud.
“We need higher taxes, we’re not keeping pace with the fraud.”
Democrats:
“Good point, tax the rich……and everyone is rich (but us, we won’t tax*US*!)!!!”
This country runs on fraud. Who knows how many BILLIONS of dollars goes to fraud. Stolen from taxpayers. Printed by Treasury. Borrowed from foreign governments. A good chunk of that to political groups with the FULL KNOWLEDGE of the politicians. Most (not all) don’t want it to stop, just look like they are trying to stop it.
Another perfect example of the economic truism that when something is subsidized, more of that something is demanded and quality diminishes. To paraphrase: good government, to the extent that it ought to be allowed, is that which is allowed to govern least.
Now, I do wonder about the claims data-entry systems! They should be able to detect and immediately flag questionable claims and providers before payment is tendered. For example, did you book more than 24 hours in a day? Do the time ranges impossibly overlap?
Being a computer geek, I can easily envision a batch process that is run as the first step of preparing a batch of claims for disbursement. It should be looking for typographic errors, and it should be looking for basic fraud. The questionable batches should then be flagged for human review.
If the system that is in place allowed this sort of fraud to take place, and did so for years, then obviously there is a complete lack of reasonable financial controls in the disbursements process.
Last year DOGE was trying to help institute the very “checks on claims” you describe.
The Courts and Congress refused to allow it for “privacy and personal data security reasons”. The same reasons being used to stop election security reforms, in the Courts and congress.
The payout system is built on trust.
Since it’s proven we are not a high trust society, the solution is to immediately shut down the payment system until safeguards and accountability are put into place. If a program is unable to be guarded, such as self-report home healthcare, than that program must be eliminated.
The amount of fraud in this country…and the others in the ‘global realm’, is astounding. I can’t wrap my head around these ‘heists of taxpayer money’. Am feeling like thieves outnumber the honest working person.
Everybody wants to get in on the act. And with no apparent oversight, is it any wonder. The examples provided of this case are so ridiculously obvious that these overpayments are just being rubber stamped. The individuals who are supposed to administer the medicare program should be jailed and heavily fined also.
(reposting this article for the umpteenth time since 2018)
In 2018 I bookmarked this article on Somalis flying out of Minneapolis–Saint Paul International Airport weekly with suitcases filled with millions of dollars stolen from American public assistance programs.
“Millions of dollars in suitcases fly out of MSP, but why?”
“Published May 14, 2018 2:00pm CDT”
“On the morning of March 15, Fox 9 chased a tip about a man who was leaving the country. Sources said he took a carry-on bag through security that was packed with $1 million in cash. Travelers can do that, as long as they fill out the proper government forms.”
“Fox 9 learned that these cloak-and-dagger scenarios now happen almost weekly at MSP. The money is usually headed to the Middle East, Dubai and points beyond. Sources said last year alone, more than $100 million in cash left MSP in carry-on luggage.”
https://www.fox9.com/news/millions-of-dollars-in-suitcases-fly-out-of-msp-but-why
How evil will the evil get?
We are seeing horror we never thought we’d see.
When obiden installed all the corrupt judges, so fast, they did what we need to do in reverse, or our society is gone.
President Trump is dismantling their $$$$. Will it dismantle the anarchy, the anti America judges? We pray it will.
Against the rules and off topic. What’s with the new conservative treehouse logo? Not loving it. FWIW
Names
https://www.justice.gov/usao-edpa/pr/dozens-charged-health-care-fraud-federal-and-state-cases-involving-576-million