14 June, 2017


Rosemary White

, February 22, 2011 9:29 am

Fraud in the Medicare system is believed to cost us between $60 – $90 billion each year.  It was just a couple of weeks ago that I blogged about this.  And then, voila’, a report of the biggest Medicare fraud bust in U.S. history:  111 doctors, nurses and physical therapists charged in nine cities.  The Feds say the scammers were illegally billing Medicare $225 million.  In the last couple of years, the Justice Department has really cranked up its efforts to go after those who are stealing from, well, all of us.   There was also another series of busts a couple of days earlier in Miami, that pulled in 21 suspects accused of bilking Medicare $200 million.  As is usually the case, crooks get greedy:

·         A podiatrist in Detroit is accused of billing Medicare $700,000 for performing complicated toenail removals.  Dr. Errol Sherman billed Medicare for 20 nail removals on three toes of one patient, according to the indictment.  He charged $110 for each procedure

·         A proctologist in Brooklyn, NY billed Medicare for $6.5 million in hemorrhoid removals, most of which, the Feds say, he never performed.  Dr. Boris Sachakov claims he performed 10 hemorrhoid removals on one patient, which authorities say isn’t possible

·         Three physical therapists billed $57 million.  Also in Brooklyn, NY, these folks are accused of paying recruiters to find elderly patients for “physical therapy” that amounted to little more than back rubs

The Department of Health and Human Services has been more vigorous in screening providers and stopping payments to suspicious ones.  But Medicare was set up to pay the providers first and then chase them if there was a problem.  The whole system has obviously gotten unwieldy because now there are 1.3 million licensed suppliers nationwide and 18,000 new applications coming in every month.  I’m hoping the rules can be changed so the penalties far outweigh the fraud.  Until next time, here’s to good planning!

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