Dr. Qamar; Institute of Cardiovascular Excellence.

» Site Navigation
Home Page The Villages Maps The Villages Activities The Villages Clubs The Villages Book Healthcare Rentals Real Estate Section Classified Section The Villages Directory Home Improvement Site Guidelines Advertising Info Register Now Video Tutorials Frequently Asked Questions
» Newsletter Signup
» Premium Tower
» Advertisements
» Trending News
» Tower Sponsors




















» Premium Sponsors
» Banner Sponsors
» Advertisements
Closed Thread
Thread Tools
  #16  
Old 01-07-2015, 10:44 AM
bimmertl bimmertl is offline
Veteran member
Join Date: Jul 2007
Posts: 693
Thanks: 28
Thanked 8 Times in 7 Posts
Default

Can't only blame people from foreign countries for fleecing Medicare. A few years back Columbia/HCA paid a 1.7 billion dollar fine for Medicare fraud and plead guilty to 14 corporate felonies. While the fraud was being committed it was run by a US born citizen and Navy veteran.
  #17  
Old 01-07-2015, 12:01 PM
janmcn janmcn is offline
Sage
Join Date: Oct 2011
Posts: 5,298
Thanks: 0
Thanked 1 Time in 1 Post
Post

Quote:
Originally Posted by bimmertl View Post
Can't only blame people from foreign countries for fleecing Medicare. A few years back Columbia/HCA paid a 1.7 billion dollar fine for Medicare fraud and plead guilty to 14 corporate felonies. While the fraud was being committed it was run by a US born citizen and Navy veteran.

At the time this was the largest case of Medicare fraud in the history of Medicare.
  #18  
Old 01-07-2015, 12:25 PM
Challenger's Avatar
Challenger Challenger is offline
Soaring Eagle member
Join Date: May 2010
Posts: 2,172
Thanks: 48
Thanked 300 Times in 124 Posts
Default

I know for a fact the names of three doctors who have been found guilty of Medicare fraud who are now practicing in TV. They have all movde here from other communities where their misdeeds started .

Always Google any new provider. Try yours now , some of you will be quite shocked.
__________________
"All that is necessary for the triumph of evil is that good men do nothing" Edmund Burke 1729-1797
  #19  
Old 01-07-2015, 02:12 PM
graciegirl's Avatar
graciegirl graciegirl is online now
Sage
Join Date: Mar 2008
Posts: 38,381
Thanks: 3,165
Thanked 2,748 Times in 1,005 Posts
Send a message via AIM to graciegirl
Default

Quote:
Originally Posted by Challenger View Post
I know for a fact the names of three doctors who have been found guilty of Medicare fraud who are now practicing in TV. They have all movde here from other communities where their misdeeds started .

Always Google any new provider. Try yours now , some of you will be quite shocked.

Why is this not public knowledge? You cannot find some of the arrest records of some local MD's either. Can you arrange to have them removed from public media and internet?

THAT is JUST not right.
__________________
It is better to laugh than to cry.
  #20  
Old 01-07-2015, 02:44 PM
Villages PL Villages PL is offline
Sage
Join Date: Sep 2011
Location: Belvedere
Posts: 5,280
Thanks: 0
Thanked 0 Times in 0 Posts
Default

I have always said that healthcare is a business and doctors/clinics are in business to make money. And just as with any other business, some will be honest and some not.

If doctors are squeezed by Medicare & Medicaid into accepting less money for their services, that may be the tipping point that starts them down the wrong path. Of course that doesn't justify their actions, I'm just saying it might be a contributing factor in some cases as some doctors may feel cheated by the system.
  #21  
Old 01-07-2015, 02:55 PM
janmcn janmcn is offline
Sage
Join Date: Oct 2011
Posts: 5,298
Thanks: 0
Thanked 1 Time in 1 Post
Post

Quote:
Originally Posted by Villages PL View Post
I have always said that healthcare is a business and doctors/clinics are in business to make money. And just as with any other business, some will be honest and some not.

If doctors are squeezed by Medicare & Medicaid into accepting less money for their services, that may be the tipping point that starts them down the wrong path. Of course that doesn't justify their actions, I'm just saying it might be a contributing factor in some cases as some doctors may feel cheated by the system.
All doctors have a choice of accepting Medicare and Medicaid or going another route. Nobody is forcing them to accept less money.

By these recent examples, it seems that The Villages attracts the rotten apples probably because of the elderly population who will accept any test ordered.
  #22  
Old 01-07-2015, 03:24 PM
blueash's Avatar
blueash blueash is offline
Soaring Eagle member
Join Date: Jan 2008
Posts: 2,343
Thanks: 118
Thanked 1,131 Times in 305 Posts
Default

Quote:
Originally Posted by Challenger View Post
I know for a fact the names of three doctors who have been found guilty of Medicare fraud who are now practicing in TV. They have all movde here from other communities where their misdeeds started .

Always Google any new provider. Try yours now , some of you will be quite shocked.
And here is the law regarding Medicare fraud and ongoing participation in Medicare / Medicaid

Quote:
Mandatory exclusions: OIG is required by law to exclude from participation in all Federal health care programs individuals and entities convicted of the following types of criminal offenses: Medicare or Medicaid fraud, as well as any other offenses related to the delivery of items or services under Medicare, Medicaid, SCHIP, or other State health care programs; patient abuse or neglect; felony convictions for other health care-related fraud, theft, or other financial misconduct; and felony convictions relating to unlawful manufacture, distribution, prescription, or dispensing of controlled substances.

The effect of an exclusion is that no payment will be made by any Federal health care program for any items or services furnished, ordered or prescribed by an excluded individual or entity. No program payment will be made for anything that an excluded person furnishes, orders, or prescribes. This payment prohibition applies to the excluded person, anyone who employs or contracts with the excluded person, any hospital or other provider for which the excluded person provides services, and anyone else. The exclusion applies regardless of who submits the claims and applies to all administrative and management services furnished by the excluded person.


There is no misinterpretation of that requirement. A person subsequent to such penalty does have the option to appeal for reinstatement. I have no idea about the typical length of the exclusion but believe it is related to the severity of the fraud. Nor do I have data on how often a request for reinstatement is granted. However, I would ask that the names of persons who are excluded from Medicare who are now practicing in the Villages, as alleged, be given to us. Fraud is a major concern and if there are practitioners practicing here who have been prohibited from Medicare participation, neither they, nor their group practice, nor their hospital can bill for that provider's services. Who are these three doctors who you know as a fact to have been found guilty of Medicare fraud? There is no concern for liability in giving us those names as truth is a defense against libel. Additionally all suspensions from Medicare as well as convictions for fraud are already public record. You may post links to the stories of their convictions if you decline to name these fraudsters yourself.

The recently enacted ACA (Obamacare) has a provision increasing the budget for detecting and prosecuting Medicare fraud. I hope (opinion) it is very successful. If you have a doctor who is waiving your Medicare copay, that may be fraud. If you are getting billed for a test you didn't need or even worse never had done, that may be fraud. Sometimes someone just clicks in the wrong place on a superbill so not all errors are fraud, but all need to be reported to clean up the problem.

Reporting fraud | Medicare.gov
__________________
I was a stranger and you WELCOMED ME : Matt 25:35, real Christianity
  #23  
Old 01-08-2015, 10:42 AM
Bethinflorida Bethinflorida is offline
Member
Join Date: Aug 2013
Posts: 47
Thanks: 0
Thanked 0 Times in 0 Posts
Default

Quote:
Originally Posted by graciegirl View Post
Do these doctors come from other countries to fleece us?

Did Bernie Madoff come from a different country?
  #24  
Old 01-08-2015, 03:53 PM
Villages PL Villages PL is offline
Sage
Join Date: Sep 2011
Location: Belvedere
Posts: 5,280
Thanks: 0
Thanked 0 Times in 0 Posts
Default

Quote:
Originally Posted by janmcn View Post
All doctors have a choice of accepting Medicare and Medicaid or going another route. Nobody is forcing them to accept less money.

By these recent examples, it seems that The Villages attracts the rotten apples probably because of the elderly population who will accept any test ordered.
Sometimes doctors don't have a choice because they are just starting a new practice and don't have enough patients.
  #25  
Old 01-08-2015, 04:40 PM
dbussone's Avatar
dbussone dbussone is offline
Sage
Join Date: Jun 2012
Posts: 7,841
Thanks: 0
Thanked 9 Times in 9 Posts
Default

Quote:
Originally Posted by Villages PL View Post
Sometimes doctors don't have a choice because they are just starting a new practice and don't have enough patients.
Poppycock!
__________________
All the great things are simple, and many can be expressed in a single word: freedom, justice, honor, duty, mercy, hope.
Winston Churchill
  #26  
Old 01-08-2015, 04:58 PM
janmcn janmcn is offline
Sage
Join Date: Oct 2011
Posts: 5,298
Thanks: 0
Thanked 1 Time in 1 Post
Post

Quote:
Originally Posted by Villages PL View Post
Sometimes doctors don't have a choice because they are just starting a new practice and don't have enough patients.
Quote:
Originally Posted by dbussone View Post
Poppycock!

And I would add, these are not struggling new doctors who are getting caught with their hands in the cookie jar. These are seasoned professionals who have learned the tricks of the trade.
  #27  
Old 01-08-2015, 06:39 PM
Paper1 Paper1 is offline
Gold member
Join Date: Nov 2011
Posts: 1,067
Thanks: 2
Thanked 70 Times in 23 Posts
Default

As long as someone else is "picking up the tab" this fraud will continue. Until the users of health care services have real skin in game, this type of crime will continue. I would offer we should empty our jails of all none violent drug offenders and fill up with our "white collars" type criminals as the are doing much more damage to our country than the drug user.
  #28  
Old 02-17-2015, 06:12 PM
nicoletta nicoletta is offline
Member
Join Date: Apr 2012
Posts: 97
Thanks: 0
Thanked 0 Times in 0 Posts
Default

they joined together but it didn't work out wonder why ?/...greed::: pure unadulterated greed look up your dr type the name and see how many lawsuits ...there are several for unqualified staff to the point of causing physical harm wrong meds dosage way to much tax invasion for husband etc etc ethic is right they have NONE ..pay attention fyi for you benefit
Department of Justice

U.S. Attorney’s Office

Middle District of Florida



FOR IMMEDIATE RELEASE



Friday, December 12, 2014

United States Settles False Claims Act Allegations Against Florida-Based Sleep Clinic And Physician For $250,000








Jacksonville, FL B The United States has settled a lawsuit against a central Florida-based sleep clinic for submitting false claims to the government. The qui tam or “whistleblower” complaint, filed by a former employee of the clinic, alleges that VMG Pulmonary and Sleep Institute and its physician/owner, Dr. Marivic Villa, violated the False Claims Act (FCA) by intentionally billing the government for hundreds of thousands of dollars of services that were not medically necessary, and that were performed by unlicensed, uncredentialed, and unsupervised employees.

The government announced today that it had reached a settlement with VMG and Dr. Villa. In reaching this settlement, the parties resolved allegations that, from January 1, 2009, until November 2012, Dr. Villa owned and operated sleep clinics in The Villages that were staffed by unlicensed and unsupervised employees. In many instances, these employees lacked the basic knowledge regarding the tests that they were performing. Despite Medicare payment rules that require that polysomnographic (PSG) tests be conducted by appropriately credentialed employees, the government contends that Dr. Villa only employed non‐credentialed employees. The government also contends that Dr. Villa continued to seek payment for claims to Medicare and TRICARE when she knew, or should have known, that she was violating the payment requirement by not having any appropriately credentialed employees administering PSG tests to beneficiaries. VMG and Dr. Villa agreed to pay $250,000 to resolve the claims.

"The United States Attorney's Office is committed to taking the steps necessary to protect Medicare, TRICARE, and other federal health care programs from fraud," said United States Attorney A. Lee Bentley, III. "By bringing FCA cases such as this, we hope to recover funds obtained through the fraud and deter others from attempting similar schemes."

This lawsuit was originally filed under the qui tam or whistleblower provisions of the False Claims Act by Donald Nichols, a former employee at the clinic. Under those provisions, a private party, known as a relator, can file an action on behalf of the United States and receive a portion of the recovery. Nichols will receive more than $50,000 as part of today’s settlement.

This settlement illustrates the government’s emphasis on combating health care fraud and marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced in May 2009 by Attorney General Eric Holder and Secretary of Health and Human Services Kathleen Sebelius. The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation. One of the most powerful tools in this effort is the False Claims Act. Since January 2009, the Department of Justice has recovered a total of more than $19 billion through False Claims Act cases, with more than $13.4 billion of that amount recovered in cases involving fraud against federal health care programs.

This case was investigated by the U.S. Department of Health and Human Services - Office of Inspector General (HHS/OIG), the Defense Health Agency (DHA), HHS Office of Counsel to Inspector General (HHS/OCIG), and handled by Assistant United States Attorney Jason Mehta.

The claims resolved by this settlement are allegations only, and there has been no determination of liability. The lawsuit against the defendants was filed in the U.S. District Court for the Middle District of Florida and is captioned United States ex rel. Nichols v. VMG Pulmonary and Sleep Institute, Tri-County Pulmonary & Multi-Specialty Group, and Dr. Marivic Villa.
  #29  
Old 02-17-2015, 06:15 PM
nicoletta nicoletta is offline
Member
Join Date: Apr 2012
Posts: 97
Thanks: 0
Thanked 0 Times in 0 Posts
Default

for every lie there are ten more unseen

certain people know the truth
Closed Thread

Thread Tools

You are viewing a new design of the TOTV site. Click here to revert to the old version.

All times are GMT -5. The time now is 08:02 AM.