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Medical Billing abuse upward of 11 BILLION

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posted on Sep, 15 2012 @ 04:37 PM
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www.publicintegrity.org...


Thousands of doctors and other medical professionals have steadily billed higher rates for treating elderly patients on Medicare over the last decade — adding $11 billion or more to their fees and signaling a possible rise in medical billing abuse, an investigation by the Center for Public Integrity has found



While it’s impossible to know precisely why doctors and hospitals moved to better-paying codes in recent years, it’s likely that the trend in part reflects “upcoding,” — the practice of charging for more extensive and costly services than delivered, according to Medicare experts, analysis of the data and a review of government audits.



Among the investigation’s key findings:

-Doctors steadily billed Medicare for longer and more complex office visits between 2001 and the end of the decade even though there’s little hard evidence they spent more time with patients or that their patients were sicker and required more complicated — and time-consuming — care. The higher codes for routine office visits alone cost taxpayers an estimated $6.6 billion over the decade.

-More than 7,500 physicians billed the two top paying codes for three out of four office visits in 2008, a sharp rise from the numbers of doctors who did so at the start of the decade. Officials said such changes in billing can signal overcharges occurring on a broad scale. Medical groups deny that.

-The most lucrative codes are billed two to three times more often in some cities than in others, costly variations government officials said they could not explain or justify. In some instances, higher billing rates appear to be associated with the burgeoning use of electronic medical records and billing software.

-Medicare administrators have struggled for more than a decade to crack down on medical coding errors and abuses, often in the face of opposition from medical groups including the American Medical Association, which helped design, and now controls the codes. Whether they make honest mistakes or engage in willful misconduct, there’s little chance doctors who pad their charges will face any serious penalties.



Let's expand federal health care!


In a related story:


Roberts was a conservative and lifelong partisan Republican. … Roberts had dual goals for his tenure as chief justice – to push his own ideological agenda but also to preserve the Court’s place as a respected final arbiter of the nation’s disputes. … A complete nullification of the health care law on the eve of a presidential election would put the Court at the center of the campaign … Democrats, and perhaps Obama himself, would crusade against the Court, eroding its moral if not its legal authority. … Gradually, then with more urgency, Roberts began looking for a way out.


www.huffingtonpost.com...


Wouldn't want to be the judge who started the movement toward reducing the power of the court, so the only logical choice is to make a ruling against your better judgement.




posted on Sep, 15 2012 @ 04:40 PM
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Which is equivalent to US costs to station Americans in Afghanistan for about a month.



posted on Sep, 15 2012 @ 04:46 PM
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reply to post by CALGARIAN
 


Right, so this must be a non-issue. When you have a deficit/debt problem like America and benefits dominate the budget, we have to take a serious look at what's going on in those sectors.

You know what also costs a lot of money? Recovering from a terrorist attack. We can speculate that these wars may be baseless, but, well, eh, not the point of this thread.



posted on Sep, 15 2012 @ 05:15 PM
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I am in favor of massive anti-corruption, anti-waste, and anti-frivilous organization..replace DHS with this organization, money well spent. the 300 dollar hammer style politics needs to stop...we can improve services, hell, even add some new ones, and reduce cost tremendously if there was such organizations -that had teeth- to its bite.

I believe the government can do great things...problem is, they are not doing it...I want a smart and open government that is thrifty. Need some economic scientists and investigators running the show..not politicians and lobbiests.



posted on Sep, 15 2012 @ 09:44 PM
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Don't get me wrong, any padding in programs needs to be cut out.

But:
What's a couple Billion in the face of Trillions?



posted on Sep, 15 2012 @ 10:02 PM
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reply to post by CynicalDrivel
 


This is a symptom of a wasteful government spending system that accounts for many more lost dollars than a few trillion.



posted on Sep, 15 2012 @ 10:18 PM
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But: What's a couple Billion in the face of Trillions?


Some things are nickle and dimed to death.

A little bit here and there adds up..



posted on Sep, 15 2012 @ 11:19 PM
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Originally posted by CALGARIAN
Which is equivalent to US costs to station Americans in Afghanistan for about a month.



No offense, but you aren't a US citizen, and clearly do not understand the issues. Since you brought up Afghanistan, what is going to cost more per 10 year period, the total war on terror for the past 10 years, or the cost to implement Obamacare over the next 10 years?

Back to the OP, part of this I bet is due to medicare changes on reimbursements. Doctors are finding they are losing money by accepting Medicare (elderly) patients. In order to keep seeing them this may be the only way they can do so. I work in geriatrics, our Attending Dr. took a greater than 30% pay cut in the past year.



posted on Sep, 17 2012 @ 07:32 AM
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The biggest scam IS spine fusion coding.

A spine fusion is when they bolt 2 spine vertebrae together. Out of San Diego came this quick procedure of going thru patients sides and ripping out their spine disc and hammering in a plastic spacer. They NEVER used FDA approved hardware to "fixate", bolt together the spine.

But they have been billing Insurance and the Government for "spine fusions". This hyper quick process has enabled spine surgeons to run thru many people every day hammering in those plastic spacers and they've been making MEGA MILLIONS...every WEEK!

Meanwhile medical journals have started releasing a little data....75% of the old people they did that procedure on....died. They never bolted their spines together. Those old farts died of an infection where they operated.

That plastic spacer was NEVER approved to be used alone, without FDA approved hardware to bolt the spine together. The FDA's looked the other way since they've been making so much money killing and maiming people.

There now is a report out saying the device/medical tools used for this type of procedure can't be disassembled so it could be sterilized.....They've known about this for years but aren't doing anything about it. They've been making so much damn money killing and maiming people...they just don't care.

"Cage Rage #1 was in the 90's"
"Cage Rage #2.....is still ongoing".

"Cage Rage".....is the unethical practice of hammering plastic spacers into peoples spines knowing they are maiming and killing because they aren't bolting vertebrae together.
edit on 17-9-2012 by Pervius because: (no reason given)



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