Propaganda Pre$$ Monitor

Saturday, August 11, 2012

Taking Command of Medicare Fraud

I'd rather the money be used for care; however, how sad is it that thi$ is even a problem in the field of health?

"Medicare fraud busters unveil command center" by Kelli Kennedy and Ricardo Alonso-Zaldivar  |  Associated Press, August 02, 2012

BALTIMORE — Medicare’s war on fraud is going high-tech with the opening of a $3.6 million command center that features a giant screen and the latest computer and communications gear, raising expectations as well as some misgivings.   

My first thought was must everything be framed in terms of war in this s*** society? My $econd was who got the contract. Then I began to ruminate how the place must look like a police command bunker or DHS fusion center. Now even the health care has gone fascist.

The carpeting stills smells new at the facility, which went live a week ago in a nondescript commercial office park on Baltimore’s outskirts.  

Do you really know what is in those office buildings and industrial parks across the country, Americans?

A couple of dozen computer workstations are arrayed in concentric semicircles in front of a giant screen that can display data and photos and enable face-to-face communication with investigators around the country.

Medicare fraud is estimated to cost more than $60 billion annually, and for years the government has been losing a game of ‘‘pay and chase,’’ trying to recoup losses after scam artists have cashed in.  

It may even be worse than scams:

Related: National Health Care: Mossad Milking Medicare

That's my diagnosis; you can make your own.

Fraud czar Peter Budetti said on a tour this week that the command center could be a turning point.

Like the turning points in all the wars?  

(Blog editor lets loose a sharp laugh of a retort)

It brings together in real time the geeks running Medicare’s new computerized fraud detection system with gumshoes around the country. Imagine a kind of NCIS-Medicare, except Budetti says it is not make-believe.

I have to tell you, readers, that this rank garbage is really making me sick (good thing I live in Massachusetts with their health plan, huh?).  

So not only with the crappy corporate health plan have to sign off on it, but now the Medicare fraud unit will have to as well?  

Btw, you can also take the references to TV, imagery, illusion, and all the wonderful script of s*** and send that back the other way, too.

‘‘This is not an ivory-tower exercise,’’ Budetti said. ‘‘It is very much a real-world one.’’

But two Republican senators say they smell boondoggle.

Utah’s Orrin Hatch and Oklahoma’s Tom Coburn say Medicare’s new computerized $77-million investment that went into operation last year is not working well. In a letter to Health and Human Services Secretary Kathleen Sebelius, they questioned spending millions more on a command center, at least until the bugs get worked out.  

So we are up to $80 million spent.

‘‘Institutionalizing relationships through establishing a [command] center may be useful, but if huge sums of money have indeed been spent on a video screen while other common-sense recommendations may have not been implemented due to ‘resource concerns,’ this seems to be a case of misplaced priorities,’’ wrote Hatch and Coburn.  

Yeah, they should have created a Pentagon procurement fraud center instead!

The two may have more than congressional oversight in mind. In an election year, Medicare fraud is an issue with older voters because it speaks to the Obama administration’s stewardship of the program.

Responded Budetti: ‘‘Our expectation is that this center will pay for itself many times over.’’

I'm sick of hearing that one when it comes to rising electricity rates to fight climate change, or all the other wonderful schemes and scams government creates. 

Enough is f***ing enough!!!!!!!!!!!!!!!!

*******************************

The new antifraud computer system aims to adapt tools used by credit card companies to stop theft from Medicare and Medicaid.  

Why not? It's a corporate government, so why not let corporate dictate the terms of your care?

 Launched with fanfare last summer, by Christmas it had stopped just one suspicious payment from going out, for $7,591. Administration officials say the system has made other valuable contributions....  

Uh-huh.

--more--" 

Wait a minute. They can build a command compound but they can't protect your identity?

"Medicare card ID protections overdue" by Sarah Parnass  |  Associated Press, August 02, 2012

WASHINGTON — Despite deep ideological divisions, Democrats and Republicans in Congress still can find common ground on one thing: their frustration with Medicare....

Medicare chief information officer Tony Trenkle indicated the process would be more complicated, involving updating IT systems, educating Medicare beneficiaries about the changes, and reassessing budget priorities laid out by Congress....  

I just want you to know, readers, that you are reading an American who is sick of lame-ass f***ing excuses. Yeah, when it comes to spying or the military and all the other crap it's taken care of right away. You and your medical concerns, Americans? Later!

Trenkle assured lawmakers that the issue of identity theft is a priority, but he could only offer a timetable for the change based on a report discredited by the Government Accountability Office, the investigative arm of Congress.  

I am GETTING SICK of seeing THAT WORD in my "newspaper."

Before Medicare officials can start stripping cards of the Social Security number, they must present a new estimate of how much such an operation would cost.

Congressional auditors said in a report that an earlier cost estimate of $800 million to $845 million was faulty....

Too low? 

Kathleen King, director of health care at the GAO, indicated that changing from a Social Security number to a new ID number would require Medicare to work with health care providers who might have antiquated systems, complicating the process.  

What did I say about excuses, readers?

--more--"

I'm sure there are some successes out there:

"Questionable Medicare billing found at 2,600 pharmacies" May 11, 2012

WASHINGTON - A pharmacy in Kansas billed Medicare for more than 1,000 prescriptions each for two patients in a single year, part of a pattern of questionable billings at 2,600 drugstores nationwide uncovered by federal investigators in a report released Thursday.

The inspector general of the Health and Human Services department found that corner drugstores are vulnerable to fraud, partly because Medicare does not require the private insurers that deliver prescription benefits to seniors to report suspicious billing patterns.

“While some pharmacies may be billing extremely high amounts for legitimate reasons, all warrant further scrutiny,’’ said the report. Medicare paid $5.6 billion to drugstores whose billings are being questioned.

The analysis broke new ground by scrutinizing every claim submitted by the nation’s 59,000 retail pharmacies during 2009 - nearly 1 billion prescriptions. Using statistical analysis, investigators were able to reveal contrasts between normal business practices and potential criminal behavior....

Medicare administrator Marilyn Tavenner said the agency mostly agrees with the inspector general’s call to action. But she suggested that requiring private insurers to monitor and report suspicious activity could place a burden on the companies and may flood government officials with leads that turn out to be useless.

Medicare also said it has antifraud contractors who are already keeping close tabs on the program.

 More on them below.

“We believe it is important to note that [the inspector general’s] report identified what appeared to be questionable billing based on its own data analysis but did not determine any actual fraud committed by the pharmacies,’’ Tavenner wrote.

The inspector general’s office says its findings are not just smoke....

A pharmacy trade group stressed that the vast majority of drugstores are law-abiding businesses....

Overall, the inspector general found only a small fraction of retail pharmacies - 4.4 percent - have telltale patterns of questionable billings. But in some parts of the country, the share was much higher, reaching nearly 20 percent of pharmacies in Miami, an area known as an incubator for Medicare fraud.

New York also stuck out, with 9 percent of pharmacies filing high numbers of questionable claims. Nationally, independent pharmacies were more likely to have problems than chain drugstores.

--more--"   

Related: Medicare fraud raids snare 107

Also see: Around New England: Cleaning Up in Connecticut

And down the memory hole it went. 

And those fraud contractors on the case?

"Medicare fraud contractors found prone to conflict" by Kelli Kennedy  |  Associated Press, July 11, 2012

MIAMI — Firms that are paid tens of millions of dollars to root out Medicare fraud are bidding on contracts to investigate companies they are doing business with — sometimes their own parent companies, according to a government report released Tuesday.... 

It occurs to me that conflict of interest is a disease.

--more--"

Related:  Hospital debt collector to pay $2.5m to settle complaint

That's one hell of a bedside manner. 

US, insurers to share data to fight health care fraud 

I was told that would be a problem above.

I'm not feeling well again.

"Hospitals slow to cut Medicare readmissions, data says" by Jordan Rau  |  Washington Post, July 28, 2012

WASHINGTON — Hospitals are making little progress in reducing the frequency at which Medicare patients are readmitted, despite a government campaign and threat of financial penalties, according to newly released government data....

‘‘We’ve put all of this policy effort into this area, and yet we’re seeing no movement,’’ said Ashish Jha, a Harvard School of Public Health professor. ‘‘Either we have no idea how to really improve readmissions, or most of the readmissions are not preventable and the efforts being put on it are not useful.’’  

Finally, some TRUTH FROM GOVERNMENT!!!  I'm feeling better already!

--more--"

Also see:  “You cannot be a first-world country without providing health care.”

Looks like you are off the list, AmeriKa. 
Posted by Rocker at 5:53 PM
Labels: American Tyranny, Health, U.S.
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