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Originally Posted by golfing eagles
I'll amplify the first part----their doctors did not know there was overbilling. While I doubt it, somebody higher on the food chain may have been in a position to manipulate the billing.
Second---what do you think medical practices spend their money on? It's not jet skis and ice cream floats. There is no conjecture about what medical practice expenses consist of. The unknown factor is any potential distributions, but I addressed that.
Third--"uneducated/careless in their responsibilities"---almost too inane to deserve a response, but....if they believe they are billing correctly, and if their consultants believe they are billing correctly, how are they careless? And speaking of conjecture, how do YOU know other practices aren't in the same boat????
PS: I have no affiliation with TVH, I've been retired for over 10 years
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You seem like you have more familiarity with this topic than most. So...
This is a big deal (and rightfully so) to people living in TV. And $360 million more or less is a LOT of money. But looking at things objectively it is (relatively speaking) peanuts. Most estimates place the amount of Medicare fraud occurring in America at the rate of $60 BILLION dollars per year. We don't know how much if any of this $360 million was intentionally fraudulent, and I am sure that it spanned years. But even if it was fraudulent and occurred all within one year it would still amount to barely 1/2 of 1% of the total Medicare fraud for that year.
OK. Given the above, what are the safeguards against fraud, if any, on the other end of the money pipeline? Aren't there watchdogs on the Medicare end of things? $360 million relatively speaking might be peanuts but $60 billion is huge. Is that particular segment of our government so clueless that $60 billion can just be explained by ignorance? Politely speaking, that possibility beggars the imagination. Or is there even the faintest possibility that fraud may be being committed on both ends?
Your thoughts appreciated.