Friday
Dec302011
60 Minutes On Medicare Fraud: A $60 Billion Crime
Medicare and Medicaid fraudsters are beating U.S. taxpayers out of an estimated $90 billion a year using a billing scam that is surprisingly easy to execute.
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The crime of Medicare fraud is bigger than the drug business in total volume.
Dec 30, 2011 at 12:47 PM
Reader Comments (27)
Why doesn't he prove how much money he can save us by going after that fraud before adding more opportunities for fraud.
What do you think Obama is really after?
I don't know if it was deliberate, but this captures the bailout zeitgeist perfectly.
Here is a solution. Volunteers. If people in every city would participate we could significantly reduce Medicare fraud.
This would involve volunteers looking in the phone book to see who is selling medical equipment in their area and visiting the street address of those companies. If upon visiting these medical equipment companies there things appeared suspicious ( no customers, no medical equipment, no personnel present, or no actual store ) they could report this to a Federal Medicare central clearing house which would investigate further.
I am sure there would be plenty of folks interested in participating and helping their country and their pocket books simultaneously. Here is a way to put Obama's focus on patriotism and national service to work and to save all of us significant tax dollars.
I tried to state it several different ways...but it's impossible....you're gonna hate it paired with how important it is to see...bailout zeitgeist it is...well put...
The law defends the plunderer.
bailout zeitgeist is good, Steve, you might like the original one.
* Democracy is an illusion that insults our intelligency, in a monetary system there is no such thing called democracy, and has never existed.
* Political parties only respond to the interest of the corporate institutions that finance and point who is going to lead the government for the next period.
* It's time now to transcend this failure and overcome any mental barrier towards other form of organization.
War is just a racket. There are only two things we should fight for. One is the defense of our homes and the other is the Bill of Rights. War for any other reason is simply a racket.
It may seem odd for me, a military man to adopt such a comparison. Truthfulness compels me to. I spent thirty-three years and four months in active military service as a member of this country's most agile military force, the Marine Corps. I served in all commissioned ranks from Second Lieutenant to Major-General. And during that period, I spent most of my time being a high class muscle-man for Big Business, for Wall Street and for the Bankers.
I suspected I was just part of a racket at the time. Now I am sure of it. Like all the members of the military profession, I never had a thought of my own until I left the service. My mental faculties remained in suspended animation while I obeyed the orders of higher-ups. This is typical with everyone in the military service.
I helped make Mexico safe for American oil interests in 1914. I helped make Haiti and Cuba a decent place for the National City Bank boys. I helped in the raping of half a dozen Central American republics for the benefits of Wall Street. I helped purify Nicaragua for the international banking house of Brown Brothers in 1909-1912. I brought light to the Dominican Republic for American sugar interests in 1916. In China I helped to see to it that Standard Oil went its way unmolested.
During those years, I had, as the boys in the back room would say, a swell racket. Looking back on it, I feel that I could have given Al Capone a few hints. The best he could do was to operate his racket in three districts. I operated on three continents.
Major General Smedley Butler, two time medal of honor recipient.
Their plans to bring down the world’s economic and financial structure is well underway. The problem is that the public has begun to discover what they are up too via talk radio, the Internet and publications such as the International Forecaster. That has caused the elitists to accelerate their plans and that has opened the window of opportunity for us.
This is why now it is the appropriate time to pass HR1207 and SB604, bills to audit and investigate the Federal Reserve. Once the public discovers what these elitists have been doing to the American people for almost a century, they will disband the Fed and turn its job of monetary policy back to the Treasury where it was placed by our Constitution. This way we will have control and transparency. The next step will be to close the revolving door between Wall Street and Washington.
So the government first steals my money (taxes are theft), then incompetently redistributes it to the sick and old through medicare such that 60 Billion a year or more is stolen and your solution is to have me (the one who's money was originally stolen) spend my time policing the streets to find the theft.
Um and maybe it's just me, but I think a better solution would be to STOP THE ORIGINAL THEFT OF MY MONEY!!!!!!!
Fraud could be much higher than $60-90 Billion.
c.200B Medicare
700B TARP
787B Keynesian "stimulus"
c.200B Iraq War
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1,887B Waste, fraud and abuse
No matter how you slice that turkey, that's a whole lot of waste, fraud and abuse. I'm with 6-year old Cody on this one.
You mean this cody of course
http://dailybail.com/home/the-next-generation-speaks-its-not-my-debt-video-collage.html
A 1% bounty on fraud prevention. Set up a hotline to the FBI/Medicare Fraud Prevention. Allow people that receive a "Explanation of Benefits" statement with fraud to report it. Also amend the law to allow for a "disputed or pending fraud inquiry" so that a proper inquiry can be processed prior to the $money$ disappearing.
This gives medicare recipients / bounty hunters the incentive to help police the transactions and instantly turns the medicare fraud targets (recipients) into investigative bird dogs. Rewards them with a fraction of the savings (helps some of the unemployed, seniors) and helps Law Enforcement by putting them onto a HOT trail.
Good idea...might be tough to implement given their size...remember they have no IT whatsoever... they need an IT overhaul as do many agencies...
The Washington Post
May 27, 2002
By Bill Brubaker
Anthony Welters grew up in a one-room tenement in Harlem, sleeping behind a curtain with his three brothers, he says. Today, he lives in a five-bedroom, seven-bathroom house on five acres in McLean. He has a 75-acre farm in the Blue Ridge Mountains. For a change of pace, there is a 5,000-square-foot house in Aspen, Colo., recently assessed at $3 million. Welters, 47, made his fortune in health insurance, serving a specialized market. The market is the poor. Federal and state audits concluded in the early and mid-1990s that ineffective oversight by Pennsylvania officials had enabled Welters and his partners to make too much money from their taxpayer-supported business. The audits said the Welters group had paid itself millions of dollars in management fees -- paid to other companies they controlled -- and millions more in bonuses.
Welters's health-insurance business expanded to New York in 1994 and New Jersey in 1996. In both states, the HMO was known as Managed Healthcare Systems (MHS). In New York, state investigators discovered something was not right about two clinics that MHS retained to serve patients in the borough of Brooklyn.
They determined that from 1995 to 1997 the clinics were being staffed largely by "unsupervised physician assistants or nurse practitioners," New York state Attorney General Eliot Spitzer announced in May 2000. The investigation also found that patients were "consistently complaining that they were having difficulty getting services or being seen by a doctor." MHS "failed to take any corrective action or properly oversee" the clinics. Spitzer announced a settlement in which MHS repaid more than $2 million to the Medicaid program for services the clinics never provided. In October 2000 MHS changed its name to AmeriChoice of New York. Anthony Welters, Chairman of AmeriChoice Corp.: "What [should] a person who takes a $200,000 investment and turns it into a billion-dollar company . . . receive? I don't know. But I know this: I'm not going to apologize for it."
<http://www.washingtonpost.com/wp-dyn/articles/A14254-2002May26.html>http://www.washingtonpost.com/wp-dyn/articles/A14254-2002May26.html
Comment: Medicaid's chronic under-funding threatens access to care for the low-income individuals covered by this program primarily because many providers will not participate at rates that frequently do not even pay overhead expenses. Several state governments have turned over their Medicaid funds to private corporations to administer these programs. Mr. Welters exemplifies how well these plans fulfill their corporate responsibility to their shareholders and executives.
Beatrice Wilkinson Welters is President Obama's nominee for ambassador to Trinidad and Tobago. No surprise, her husband Anthony Welters, is an executive with UnitedHealthGroup which brought in $200,000-$500,000 in campaign donation for the election and another $100,000 for the Obama crowning inaugural. Beatrice Welters donated $4,600 to the Obama campaign in each of the years 2007 and 2008. Her husband, Anthony donated $4,600 in 2008. The Welters' two sons were also $4,600-donors: Bryant, reportedly 19 years old today, donated $4,600 in the second quarter of each of the years 2007 and 2008, when he was an unemployed student, and Andrew, reportedly 17 years old today, an unemployed student, donated $4,600 in the second quarter of 2008.
http://maggiesnotebook.blogspot.com/2009/11/beatrice-wilkinson-welters-ambassador.html
BACKGROUND*
Anthony Welters has been President of Public and Senior Markets Group at UnitedHealth Group Inc. since September 2007. Mr. Welters has been Executive Vice President of UnitedHealth Group Inc., since December, 2006. He serves as Chief Executive Officer of AmeriChoice Health Services, Inc. He served as Head of Public & Social Markets Group of UnitedHealth Group since August 2007. Mr. Welters co-founded AmeriChoice Corporation (AmeriChoice) in 1989 and served as its Chief
Among its provisions, the anti-kickback statute penalizes anyone who knowingly and willfully solicits, receives, offers or pays remuneration in cash or in kind to induce, or in return for: A. Referring an individual to a person for the furnishing, or arranging for the furnishing, of any item or service payable under the Medicare or Medicaid program; or B. Purchasing, leasing or ordering , or arranging for or recommending purchasing, leasing or ordering, any goods, facility, service or item payable under the Medicare or Medicaid program. Violators are subject to criminal penalties, or exclusion from participation in the Medicare and Medicaid rograms, or both. A violation of the anti-kickback law is a felony offense that carries criminal fines of up to $25,000 per violation, imprisonment for up to five years and exclusion from government health care programs.The federal anti-kickback statute, 42 U.S.C.§ 1320a-7b(b), prohibits individuals or entities from knowingly and willfully offering, paying, soliciting or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid or any other federally funded program.
If this were any one person they would be in jail now, if the FBI were called in on this matter they would be in jail now, if the IRS were notified they would be in jail now.Since all Ameri-Choice checks come from the United Health's home office they should be held equally responsible for any bribes, kickbacks, Stark, Fraud and inducements violations that have occured. Federal and State Governments have developed such a depended position with this company that laws and rules no longer apply for them.This role is nothing new for the AmeriChoice people and its been going on for years, look at some of the prior news articles that date back for years only now they can afford to hire the best of Law firms and give the most for Political contributations all on the back of the taxpayer.The Laws have become tighter for sure but they can still dance away their problems.
By Wayne Barrett Tuesday, Jul 3 2001
Most of Bill Thompson's "financial consulting" clients are not revealed on his Board of Ed disclosure forms. The most disturbing one that Thompson did list, however, was Managed Healthcare Systems Inc., where he earned a total of $65,000 in 1997 and 1998, according to his tax returns. A black-owned HMO whose principals worked at the highest levels of the Reagan administration, the company is shrouded in scandal.
Last year, New York Attorney General Eliot Spitzer forced the MHS, which specializes in recruiting Medicaid recipients for its HMO, to repay the state $2 million for Medicaid services that patients never received. Spitzer also put Jean Moise Millien, the director of an MHS clinic, in jail for up to three years after he pled guilty to stealing $275,000 from Medicaid. Spitzer's press release revealed that MHS knew for years that Millien's clinic, Stuyvesant Heights Medical Group, was largely run by "unsupervised physician's assistants and nurse practitioners" and that patients "were consistently complaining that they were having difficulty getting services."
Yet, said Spitzer, the company "failed to take corrective action or properly oversee its subcontractor." MHS portrayed itself as "a victim" of the clinic when they settled with Spitzer.
The State Health Department also revoked Millien's physician's assistant license in November 2000, finding that he'd run the clinic since 1991—four years before the MHS contract began—without on-site supervision by a licensed M.D. The Department also found that the clinic corporation had been dissolved by state officials for tax delinquency reasons in 1994 and that Millien had a prior criminal record. Spitzer said a doctor from Pennsylvania came to the clinic once a week "to sign charts" for a while, but "eventually stopped coming altogether."
An MHS affiliate left a similar trail of complaints in Pennsylvania—where it became the subject of Philadelphia Inquirerexposés in 1996 and 1997, before and during Thompson's employment. According to one study, it was three times as likely to refuse to pay for days of hospital care as the state's next most stingy HMO. The "focus of six special state and federal audits" and a onetime target of a Pennsylvania grand jury, according to the Inquirer,the company took a reported $119 million in profits and executive bonuses from its Pennsylvania Medicaid work alone in the early '90s, making it the "most profitable HMO" in the state. Anthony Welters, the principal owner of AmeriChoice, the Virginia-based parent of MHS, was a top Reagan transportation official, gave $20,000 to Pennsylvania GOP governor Tom Ridge, and has given over $56,000 in recent years to Republican candidates and committees across the country. Clarence Thomas is the godfather of one of his children. Thelma Duggin, another top executive, worked in the Reagan White House and at the Republican National Committee under Lee Atwater, the engineer of the Willie Horton campaign. Thompson said he'd known Welters and Duggin since 1992, when they started trying to do business in Brooklyn, and that he "bumped into Tony" in 1997 and Welters offered him a consulting job that started that June. Charged with "reaching out and helping them obtain business," Thompson said he "spoke to community organizations." Though he says he "never visited an MHS clinic"—including the Stuyvesant Heights one near his home—he insists that MHS is "a good company." While Thompson's tax returns indicate that AmeriChoice paid him $35,000 in 1998, his disclosure forms report no income from the company.
AP
Published: September 24, 1988
SAN FRANCISCO, Sept. 23— Health care executives in several states and a health care provider have been indicted on Federal charges in connection with kickbacks in return for employee benefit contracts with businesses and labor unions. Richard Held, chief of the Federal Bureau of Investigation here, said such kickbacks were ''adding another dollar or two'' to the health premiums of many workers. The indictments were against 10 people and United HealthCare Inc. of Baltimore, a health benefit concern, on charges that included racketeering, embezzlement and falsifying records. They were unsealed Thursday in San Francisco, Atlanta, Baltimore, Chicago and San Diego.
Bill Slavin, president of United HealthCare, said the concern was ''innocent of all charges.'' The authorities said the central figure in the case was Angelo Commito, 43 year old, of Fairfax, Calif., who was described as a broker in the business of lining up health benefit contracts for companies and unions. The authorities said he was arrested Thursday in Palm Springs and was released on $1 million bail. Mr. Commito made no immediate comment on the indictments. #3-Year Underecover Inquiry Federal agents working under cover handled thousands of dollars in kickbacks for securing health benefit contracts for companies and labor unions in a three-year investigation, officials of the Justice Department said. The kickbacks, collected by representatives of health plans and brokers, were in addition to commissions that brokers charge for arranging contracts, the officials said.
One of the indictments says a bureau agent was promised $7,500 a month by brokers if he could secure a health benefit contract at the National Semiconductor Corporation of Santa Clara, Calif. The money, which was never paid, would apparently have been charged to the employer. Among the individuals indicted were an executive of United HealthCare and the former benefit plan managers for two Chicago-based labor unions. In the indictments returned in Atlanta, Mr. Commito and five other people were accused of conspiracy, mail fraud, wire fraud and money laundering in a plan to defraud the Munford Corporation, a retailing concern, and its employee welfare plan in the selection of a second prepaid optical program and an alcohol and drug abuse counseling program.
The authorities said the fraud involved using Mr. Commito's companies to pay kickbacks to a Government agent who posed as Munford's representative for the purchase of the programs. United HealthCare, which provides prepaid optical, dental and medical prescription services to more than a million families in 42 states, is accused of taking part in the scheme to pay the government agent who was soliciting an optical contract for employees of Munford.
Mr. Commito and another man were also accused of devising a scheme to defraud National Semiconductor of money the two agreed would be used to pay kickbacks to a government undercover agent who posed as the company representative, the authorities said. The kickbacks were to persuade the concern to buy an alcohol and drug rehabilitation program, they said. Kickbacks Linked to New Plans United States Attorney Joseph Russoniello of San Francisco called Mr. Commito ''a known associate of traditional organized crime individuals.'' The charges against him include violating the Racketeer Influenced and Corrupt Organizations Act in schemes against four benefit plans. The charges carry a maximum sentence of 20 years in prison and a $250,000 fine. At a news conference, Mr. Russoniello said certain types of health benefits that a number of states now require that companies provide, such as drug and alcohol rehabilitation, appeared to be particularly attractive targets for corruption in the soliciting of benefit contracts. ''The amount of money that passes through this kind of program has made it ripe for the plucking,'' the prosecutor said. ''It's difficult to know how widespread, nationally, the abuse is.'' He said the Justice Department would seek to consolidate all the cases in San Francisco
Protected vendor status sure, politics sure, limited government budgets sure, Federal and State officals looking the other way sure, and rather then stop these activities a strong desire not to rock the boat exist. Even with the vast changes in rhe laws and budgets,a hands off policy remains, you tell me what's wrong with this picture?
The Government created this monster and now they don't know what to do about it, like shooting yourself in your own foot etc.Tons of money to advance their national growth, its market positions, tons of money for political donations, tons of money to send 75 millon back to its home office from New York state alone, tons of money to suppot National TV shows, tons of money to pay hugh State fines, tons of money to hire the very best law firms, tons of money to pay for bribes and kickbacks, tons of money for hugh salarys and bonuses, all done on the back of the American taxpayor, you see this company receives all its money from the Federal government.
Should your tax dollars be held to a higher standard? Should the government agencys responsible for there review be held to that same standard? Should the IRS audit their corruption? Why has this company not been charged? How long can the buck be passed here in more ways then one? Hey, it's your tax dollars don't complain now.. then don't complain later on...
The transportation used were 'limo-carriers' from the Newark area.This also seems like a great idea to help those who can't help themselves of course its with the taxpayer who foots this bill for these benefits as well as the many others offered under the Plan. This Limo-services supplied a pick up service and and return service for the duel beneficiarys to go to their Doctors, get their prescriptions filled, grocery shopping, and once a month to go to a free movie at a local Newark theater once again all on the back of the taxpayer. Their Brochure goes on to say when you enroll with AmeriChoice Personal Care Plus you get more benefits, and more coverage,more personalized care and more services than Medicaid and Original Medicare.
I'm not attacking the poor or any of these wonderfull programs beng offered for medicare and medicaid folks, I'm sure these benefits were well thought out and by those responsible for such thrifty decisions etc. But I would like to question the grocery trips and theater trips and how this all relates to any taxpayors interest, All these new great Audit teams that report to CMS now, I'm sure if they uncover any thing wrong, it will be brought to our attention and corrected if necessay and any taxpayors money loss will be returned then will be protected.
I would like to know how this is not considered a major inducement under the Medicaid rules and regulations, you know to get those millions of Americans signed up that AmeriChoice Health keeps talking about. I wonder what roll the States play in this limo matter, and if Congress really knows how these tax dollars are being spent on limos to go to the movies?
The problem occurs when writing one up to come on board with AmerIChoice Health a second application is written for this above benefit even though they have not been accepted into the AmeriChoice health plan. It sounds to be a minor issue buts its not, you see this benefit and its application for this benefit are completed at the very same time the application is written for AmeriChoice Health. Now , remember your dealing with older Americans and their mind is on the "Response Emergency System etc. and you have used..... this benefit..... as a formal inducement...and even took an application on it so as to have them change.
This is against all the Inducement rules regulations and laws.This matter was brought to everyone's attention both inside and outside of AmeriChoice yet, is was as all else ignored. The refusal by the company to conform and not take an application for this benefit till they were approved with AmeriChoice started to set the mood ongoing for many terminations, and yes I was fired. This was only one of dozens of rules laws and or violations that were brought to their attention as well as the federal agency's outside their Home Office In Newark and ignored.
Here are few things that were told to me, don't rock the boat, nobody cares, Take you pay check and keep your mouth shut, will have you report early everyday in Newark before you day starts and or you will have report late at night until you understand your position with the company, we will delay or not approve expenses and on and on etc. I was even told by a person who worked at CMS I would be the one in trouble for making these violations a big deal .... The problem was as a licensed agent it violated all the laws rules and regulations that controlled my license and any sales effort including the use of their illegal forms being used. A Federal Judge reviewed these issues as well as others and thought them trivial, I was very sorry to hear this since it cost me as well as others, our jobs.
If the Inducement laws are not going to be enforced why do you need licensed agents to market the products? Thousands of tainted sales being made and yes its true nobody cares.
The difference in the law as applied to a "person vs a corporation" on one hand the corporation, has a formal contract signed with the government not to break the health laws,, rules and regulations, so any violations that occur now become trivial, as well as evidence recovery denied, jury trial denied, and of course any claims submitted to the government really don't exist. The person a doctor not a corporation, jury trial allowed, evidence gatherning allowed, of course no formal contract signed with the government his mistakes are real. The very same laws ,rules and regualtions in place apply to both but this means that any person is now screwed and must go to jail.There are a lot of lessons to learn from this unfortunately don't violate the law is not one of them.
It’s true that relators argued that because United Health agreed to comply with all those trivial regulations when it contracted to become a prescription drug plan sponsor,as well as sign a formal contract of compliance. The court found such a theory of liability overly broad. “If Relators’ theory were correct,the FCA would become a federal tort fountain, flowing claims for every trivial violation of Medicare/Medicaid regulations,”the court said. Relators next argued that under the recently enacted Fraud Enforcement and Recovery Act of 2009 (FERA) a relator need only show whether compliance with regulations would have a tendency to influence the government’s payment decision. While that argument is true, the court reasoned, “Relators must still show a claim . . . and they have not done so.”Turning next to relators’claims based on alleged violations of the Anti-Kickback Statute, the court concluded relators failed to allege “that United Health certified compliance with the Anti-Kickback Act, nor did they allege that such compliance was relevant to the Government’s funding decisions.” The court then declined to exercise supplemental jurisdiction over relators’state law claims and refused to grant relators leave to amend.
Case1
Fifth Circuit Ruling Affirms that Psychologists are Not immune from Fraud and Abuse Scrutiny September 6, 2010 Posted In: Compliance , Stark and Anti-Kickback By The Health Law Partners on September 6, 2010 9:13 AM | Permalink
Dr. Sam Smith Hill, III's 2008 healthcare fraud conviction was affirmed by the 5th Circuit on August 25, 2010 (US v. Hill, No. 09-40749 (5th Cir. Aug. 25, 2010). Found guilty in five counts of healthcare fraud by a jury, Dr. Hill's indictment alleged that he fraudulently billed Medicaid from 2001 to 2008. Having founded a children's behavioral clinic in Corpus Christi, Texas that provides psychological services to underprivileged children, the indictment contended that Dr. Hill billed Medicaid for services performed by his Licensed Psychological Associates (LPAs). The Texas Medicaid guidelines prohibit billing Medicaid for services not rendered by a physician. Dr. Hill asserted that he only billed for the work he performed; however, the 5th Circuit disagreed, citing Dr. Hill's statements to FBI agents claiming "that he knew he was violating Medicaid billing rules, but that the rules were 'wrong and immoral.'" The court, thus, found there to be "sufficient evidence from which the jury could conclude that the billing included the LPA time," affirming the lower court's conviction.
While not given as much attention as other fraud and abuse violations, even mental health professionals must be aware of increased fraud and abuse scrutiny.
For more information, please contact Abby Pendleton, Esq. or Robert S. Iwrey, Esq. at (248) 996-8510, or visit the Fraud and Abuse specialty page, the Compliance specialty page, or the HLP website.
Case2
FCA claim alleging aggressive marketing tactics by health plan provider dismissed
Publication: Health Law Week
Date: Friday, June 4 2010
The U.S. District Court for the District of New Jersey dismissed a qui tam action brought by two former employees of healthcare plan providers alleging violations of the False Claims Act (FCA) arising from excessively aggressive marketing methods. United Health Group Inc., a provider of access to healthcare services, had as its subsidiaries AmeriChoice and AmeriChoice of New Jersey, which each offered Medicare Advantage plans. Charles Wilkins and Darryl Willis (the relators), who were each employed by United Health Group and AmeriChoice, initiated a qui tam claim against United and its two subsidiaries under the FCA alleging numerous violations of Medicare and Medicaid regulations governing administration of the Medicare Advantage plans. The complaint alleged that the defendants engaged in unauthorized and aggressive sales methods in marketing the plans -- including the provision of illegal cash payments to providers to induce them to change beneficiaries to AmeriChoice and the provision of illegal kickbacks to doctors for obtaining the names of patients they could call and approach. The defendants moved to dismiss. The district court concluded that the complaint failed to identify a single instance in which the defendants submitted a false claim to the government for payment as required to prosecute a qui tam claim as relators under the FCA. Under applicable federal appellate court precedent, the absence of such an allegation was fatal to the relator's false certification claim. The relators' theory of liability at base was that because United Health agreed that it would comply with all Centers for Medicare and Medicaid Services regulations, and because it was at times in violation of some regulations, it committed fraud each time it submitted a claim for payment. The district court concluded that this contention confused the conditions of participation in a Medicare or Medicaid program with the conditions of payment, and would open the door to a flood of tort claims of a type not contemplated by the FCA. Moreover, the complaint failed to allege that the violation of any regulation was actually relevant to any funding decision. As a result, the complaint failed to state a claim on which relief could be granted and, accordingly, the defendants' motion to dismiss was granted.
Source: Health Law Week, 06/04/2010
Copyright © 2010 by Strafford Publications, Inc. http://www.straffordpub.com / All rights reserved. Storage, reproduction or transmission by any means is prohibited except pursuant to a valid license agreement. "
In September, insurance company AmeriChoice brings trucks to blighted neighborhoods in New York City and gives away coupons for "free chickens" as an incentive for the underprivileged to switch their Medicare coverage. New York state senator Carl Kruger files a complaint with the state attorney general. The 101 Dumbest Moments In Business 2003 EDITION - April 1, 2003 Apr 1, 2003 ... Just don't tell him about the "Chinese health balls." ..... In September, insurance company AmeriChoice brings trucks to blighted ... New York state senator Carl Kruger files a complaint with the state attorney general..... Falling on his sword, Welch announces he'll give up most of the perks,...2009 and 2010 $120,000 from your tax dollars.
Philadelphia PA Mayor Nutter received two years in a row $60,000 checks to help keep open and operate the city swimming pools. These checks came from AmeriChoice Health and on the surface seems like fine gifts. Yet, they are Bribes non the less, these checks come from a company who receives all its money from the Federal Government as a vendor for Medicare Medicaid services is not allowed to offer bribes kickbacks and money gifts of any kind in order to promote its share or induce its share of the market place. This is not allowed as a use of your taxpayers dollars, yet it happens.What does it really cost the City of Philadelphia to receive this money? Americhoice Health has a long history of corruption over the years yet seems to be protected by those who are responsible to over see their actions why is that? PS... Did the Mayor send for Chicken Man or was he approched by Chicken Man? The Mystery Widens! Can Chicken Man save the Liabraries?
CEO of AmeriChoice Health Bolts.. Was that Chicken Man? John J. Kirchner - Director, Operations John Kirchner joined Healthfirst in May 2010 with over 25 years experience in health care management. Mr. Kirchner’s background includes responsibility for health plan P&L, strategic planning and operations, and government and regulatory affairs. Mr. Kirchner will be responsible for supporting all aspects of NJ health plan operations. Prior to joining Healthfirst, Mr. Kirchner held a variety of positions at AmeriChoice of New Jersey serving as President from 2007 through 2009.
Will this mystery man or woman or chicken ever be caught? Will the "secret eggs" given out to housing authority officers Clinics, Doctors and whoever, make it into through that crispy crust prepared by their Home Office Line Chefs?. Will the Doctors who collected all those extra eggs for sharing thier patients recipes with the Home Office Line Chefs ever really be rewarded? Will the Great Head Chef Chicken Man or whomever that directed and approved all to avoid, overlook the rules, laws and regulations Menu, ever be really compensated for their true worth or will Salmonella remain the dish served for Medicare and Mediciad Industry.
PS Is the Chicken Man a Blues Brothers Wanna B???
Medicare.gov as well as other Federal agency's encourage you to report any fraudulent activities, yet, the same government agencys were notified the way this company does business yet did nothing. Three years ago they were reported to these Federal agency's and as of todays date not only were they allowed to continue doing business but were never charged once. Protected vendor status sure, politics sure,limited government budgets sure, Federal and State officals looking the other way sure, and rather then stop these activities a strong desire not to rock the boat existed. Even with the vast changes in the laws and budgets,a hands off policy remains, you tell me what's wrong with this picture? The Government created this monster and now they don't know what to do about it, like shooting yourself in your own foot etc. Tons of money to advance their national growth, its market positions, tons of money for political donations, tons of money to send 75 millon back to its home office from New York state alone, tons of money to suppot National TV shows, tons of money to pay hugh State fines, tons of money to hire the very best law firms, tons of money to pay for bribes and kickbacks, tons of money for hugh salarys and bonuses, all done on the back of the American taxpayor, you see this company receives all its money from the Federal government. Should your tax dollars be held to a higher standard? Should the government agencys responsible for there review be held to that same standard?Should the IRS audit their corruption? Why has this company not been charged? How long can the buck be passed here in more ways then one? Hey, it's your tax dollars don't complain now.. then don't complain later on…
ps… I know times are tough for a lot us, but it would be great to have a free limo to go to the Doctors, Pharmacy, Movies, Grocery shopping, and given free tickets for the movies. Offered soda, pop corn and hotdogs, as well as have them receive free coupons for Grocery items……Kind of makes you wish you also had Medicare and Mediciad right?
Over the course of three years, Berman’s lobbying firm was paid $660,000 to lobby on behalf of UnitedHealth subsidiary Americhoice, a managed care HMO providing health insurance to Medicaid, Medicare, and SCHIP recipients. Specifically, according to the lobbying report, they lobbied on Medicaid issues in the Deficit Reduction Act of 2005. [Americhoice Lobbying Reports 2004 – 2007; Americhoice.com]
Berman Also Lobbied For “Absurdly Low” Rates for Medicaid Managed Care Companies to Pay Out of Network Hospitals.
Also included in the DRA, and mentioned as a lobbying issue on Berman’s Americhoice lobbying report, was a provision setting rates managed care companies must pay to out-of-network providers -- mainly hospital emergency rooms -- for care received by Medicaid beneficiaries. Rather than forcing managed care companies to reimburse out-of-network hospitals an amount comparable to network providers, the legislation set the default amount to the state’s “fee-for-service rate,” which often is “absurdly low.” The provision thereby shifted financial responsibility for services to Medicaid beneficiaries from the managed care companies to the hospitals themselves, permitting managed care companies to rake in huge profits, while hospitals incurred added losses. [Modern Healthcare, 1/29/07; Text of S. 1932]
To Save Money, Bill Cut Services to Medicaid Beneficiaries, But Left Managed Care Providers Untouched.
Under the final budget package, substantial Medicaid spending cuts were achieved by imposing new premiums and increased co-payments on Medicaid beneficiaries; some costs were also shifted to the states, who in return were awarded new powers to drop coverage or reduce benefits to certain beneficiaries. In a letter to Senate Majority Leader Bill Frist, the AARP CEO decried the final bill, saying it “protects the pharmaceutical industry, the managed-care industry and other providers at the expense of low-income Medicaid beneficiaries.” [Inside CMS, 12/29/05; Los Angeles Times, 12/22/05; World Markets Analysis, 12/21/05; The Hill, 12/20/05]
She can also tell you what entertainer in Branson, that has no money and is living on the system, wile being a star up on the "Branson Strip".......................I could "Name Names", but I cant. ......
The goverment has set it up for their Dem. friends to make a killing on the American People. You should see the Fire in Her Eyes, when she walks in and says...................."Make Me a Drink"................?
Its OK to steel money from us if your a Dem. or a Rep. its how it works........ The more ass holes stealing money from us is a "Vote" for the Dems...........and that is why they control the system....!
SPREAD THE TRUTH AND REPORT ALL THE CORRUPTION NO MATTER HOW SMALL YOU THINK IT IS.