When you think of Medicare fraud and Medicaid fraud, do you picture some guy getting health care he doesn't deserve with a fake Medicare card? The reality is that the same people that want to kill the new health care law are in many cases the same people that have been caught repeatedly defrauding Medicare and Medicaid...by that I mean, "medical device manufacturers, nursing home chains and other major health care enterprises". And they just pay a fine and walk away. There is no incentive to not defraud the system until now. WASHINGTON -- It's getting personal now. In a shift still evolving, federal enforcers are targeting individual executives in health care fraud cases that used to be aimed at impersonal corporations. The new tactic is raising the anxiety level – and risks – for corporate honchos at drug companies, medical device manufacturers, nursing home chains and other major health care enterprises that deal with Medicare and Medicaid. Previously, if a company got caught, its lawyers in many cases would be able to negotiate a financial settlement. The company would write the government a check for a number followed by lots of zeroes and promise not to break the rules again. Often the cost would just get passed on to customers. Now, on top of fines paid by a company, senior executives can face criminal charges even if they weren't involved in the scheme but could have stopped it had they known. Furthermore, they can also be banned from doing business with government health programs, a career-ending consequence. Many in industry see the more aggressive strategy as government overkill, meting out radical punishment to individuals whose guilt prosecutors would be hard pressed to prove to a jury. The feds say they got frustrated with repeat violations and decided to start using enforcement tools that were already on the books but had been allowed to languish. By some estimates, health care fraud costs taxpayers $60 billion a year, galling when Medicare faces insolvency. "When you look at the history of health care enforcement, we've seen a number of Fortune 500 companies that have been caught not once, not twice, but sometimes three times violating the trust of the American people, submitting false claims, paying kickbacks to doctors, marketing drugs which have not been tested for safety and efficacy," said Lewis Morris, chief counsel for the inspector general of the Health and Human Services Department. "To our way of thinking, the men and women in the corporate suite aren't getting it," Morris continued. "If writing a check for $200 million isn't enough to have a company change its ways, then maybe we have got to have the individuals who are responsible for this held accountable. The behavior of a company starts at the top." Lawyers who represent drug companies say the change has definitely caused a stir, but the end result is far from certain.
Does the name Rick Scott suddenly have more meaning? Instead of electing these people to office, they should be in jail.
I Googled "medicare fraud conviction" and the stories are almost all businesses or large organization defrauding Medicare or Medicaid. Look at the sentences these two individuals are looking at for trying to get powerchairs from Medicare yet we fine huge corporations and convict no one. Double standard nonsense. Two Houston-Area Residents Convicted in Medicare Fraud Scheme Involving Fraudulent Claims of Hurricane Damage to Power WheelchairsA federal jury in Houston today convicted Helen Etinfoh, 50, and Paula Whitfield, 43, for their roles in a Medicare fraud conspiracy involving, among other things, fraudulent claims of hurricane damage to power wheelchairs, announced the Departments of Justice and Health and Human Services (HHS). After a week-long trial, the jury convicted Etinfoh of one count of conspiracy to commit health care fraud and four counts of health care fraud. The jury convicted Whitfield of one count of conspiracy to commit health care fraud and one count of health care fraud. Each conviction carries a maximum sentence of 10 years in prison and a $250,000 fine. Following the jury verdict, Etinfoh was ordered to be detained pending sentencing by U.S. District Judge Ewing Werlein Jr. According to evidence presented at trial, Etinfoh was the owner and operator of Luant & Odera Inc., a Houston-area durable medical equipment (DME) company doing business as Tonni Medical Equipment & Supplies. Evidence presented at trial established that Whitfield was a recruiter for Luant who was paid kickbacks in exchange for providing the company with beneficiaries in whose names bills could be submitted to Medicare. Evidence at trial showed that Etinfoh and other co-conspirators submitted false and fraudulent claims to Medicare for medically unnecessary DME, including power wheelchairs, wheelchair accessories and motorized scooters. Many of these claims were submitted based on information supplied by Whitfield.
I'm all for prosecuting people and companies that commit Medicare fraud, but if someone didn't know it was occurring I don't think they should be held liable. Now if it's been proven that they could have prevented it from occurring, but ignored it (for whatever reason... whistle-blower laws are in place, though they can sometimes fail a person), then I'd want them prosecuted. What the (deleted) were they waiting for?!! Why create laws then allow them to 'languish'?
I'd have to say that the repeat offenders are doing it knowingly and they are just gambling that they won't be caught. And if they do get caught, they are hoping that the fine is less than they have stolen. Jail time would be a bit more incentive to not do it in the first place. I say pay rewards and grant immunity to whistle blowers so that it would be profitable to turn these dishonest businesses in and make them pay the whistle blower's reward. Laws are regularly not enforced when there are big donors involved. Even if these people are caught and convicted they usually get pardoned. Not that it even makes it that far in most cases. We have two systems of justice in this country. The one you and I are subject to and the one where you get as much justice as you can afford.
I agree. I'm all for prosecution of people in addition to penalties to the corporations. These people have been using the protections corporations provide as cover for their crimes. It's good to see the change in policy. I've heard of some whistle-blowers being (deleted) by the system, and think they need better protection. All-in-all, an improvement to the system.
Interesting approach. So BO should be charged for Rangle's problems. Jefferson's problems, Blogo's problems, etc. Where does it end?
So knowing that your company is defrauding Medicare and doing nothing to stop it is OK? In most crime situations that would make you an accomplice, an accessory, or a co-conspirator. But you two think that these people defrauding the tax payers should be cut some slack? Why did I know that you'd probably side with the criminals? Oh yeah, the quest for the almighty buck should be without barriers legal or otherwise. I forgot the Right wing mindset for a moment.
Knowing that your company is defrauding Medicare and doing nothing to stop it is, TTBOMK, a crime. That is not what "it had they known" says or means.
