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re: Zachary lab owner faces Medicare, Medicaid fraud charges
Posted on 12/5/23 at 11:44 am to DWaginHTown
Posted on 12/5/23 at 11:44 am to DWaginHTown
If they do this to medicare and medicaid imagine the absolute racket that they run on work comp and private insurers when it isn't even a federal crime. We are so screwed.
1
Posted on 12/5/23 at 12:33 pm to DWaginHTown
Did he send the complete test results to the physician who ordered the tests? If so, then did none of these doctors ever wise up to what was going on and complain?
If that's true then I think there's some shared culpability there... maybe not enough to send anyone to prison, but certainly enough to kick some doctors out of Medicare. Some of them would have been receiving multiple unwanted test results back from this guy every day.
If that's true then I think there's some shared culpability there... maybe not enough to send anyone to prison, but certainly enough to kick some doctors out of Medicare. Some of them would have been receiving multiple unwanted test results back from this guy every day.
Posted on 12/5/23 at 12:44 pm to Porpus
Because the doctors were likely getting kickback payments.
Posted on 12/5/23 at 12:48 pm to benson32
quote:
Because the doctors were likely getting kickback payments.
Yeah, I saw something about kickbacks in a non-Advocate article I found. Seems to me, if all this guy got to do was fix up his truck and his pool, he must have spent an awful lot on those kickbacks.
Maybe he's cooperating with the feds, and they plan to charge the doctors who really made this scheme possible / collected the profits.
Posted on 12/5/23 at 12:50 pm to DWaginHTown
This place is next door to my business. I remember watching federal agents going in an out of there carrying all sorts of boxes and items. I knew that it shut them down, but I never really knew what exactly happened.
Posted on 12/5/23 at 12:54 pm to deathvalleytiger10
beautiful house...
Posted on 12/5/23 at 12:59 pm to DWaginHTown
InRegister LINK
The more the merrier: No room or outdoor space is untouched by the Christmas spirit at the Zachary home of Heather and Brad Schaeffer
The more the merrier: No room or outdoor space is untouched by the Christmas spirit at the Zachary home of Heather and Brad Schaeffer
Posted on 12/5/23 at 1:22 pm to DWaginHTown
This exact same thing happened to a physician in Baton Rouge few years ago. I was engaged to his sister in law.
Posted on 12/5/23 at 4:15 pm to tigerfoot
This is now illegal due to STARK laws.
Posted on 12/5/23 at 4:19 pm to Porpus
Usually they are integrated into the physicians EM/HR. If the doc orders a 12 panel. Lab runs 22, sends the results on all 22, but the physician would only see the 12 unless they pulled up the entire lab report which shows up as an attachment on the patient chart.
Posted on 12/5/23 at 5:20 pm to redstickrick
quote:
If they do this to medicare and medicaid imagine the absolute racket that they run on work comp and private insurers when it isn't even a federal crime. We are so screwed.
The counter argument is medicare and medicaid is monitored by government agencies that are either incompetent or don't care and thus a much softer target.
Posted on 12/5/23 at 5:56 pm to LSUfan4444
quote:
Original Medicare is an absolute joke. A complete waste of money unless you're one of the thousands of physicians, facilities or systems that abuse, fraud or overuse it to the tune of $100+ billion each year.
Exactly. That’s why Medicare pays these private insurance companies to enroll beneficiaries into their plans and thereby “privatizing”their Medicare. So in this case, the lab would be billing Humana or Blue Cross for example, instead of Medicare.
Posted on 12/5/23 at 6:01 pm to DWaginHTown
The Taliban probably would have executed him which is fine by me…. Shame our legal system is so weak
Posted on 12/5/23 at 6:26 pm to DWaginHTown
quote:
In 2016, the U.S. Department of Health and Human Services alleged that the patients of the MedComp Sciences lab were in “immediate jeopardy,” based on a surprise inspection of the lab by federal employees in July of that year.
The Department of Health and the Centers for Medicare and Medicaid Services said in court filings that the Zachary company failed to refrigerate urine samples properly or correctly label the samples and also failed to ensure the samples were free from debris before testing, the Advocate reported then.
I don't understand how he ran the lab after 2016. The initial charges "failed to refrig urine samples properly, correctly label, and ensuring the samples were free from debris" can literally be found in every lab in the USA. An inspector can go through a thousand specimens and if one label was partially torn and part of id missing, then its a write up and the write up will always sound like you did this on every spec. Failing to refrig properly can literally mean you failed to write a sentence on one out of 15 urine tests in your procedure manual. Free of debris? Urine will accumulate "debris" before and after testing....maybe they simply didn't document a centrifugation.
Bottom line is that the CEO was stupid if he thought they weren't in the feds crosshairs. You get a surprise inspection from CLIA and you just bend over and take it and correct all the "mistakes". I've restarted several labs that were close to being shut down and one that was. It was eye-opening, but none of the labs in reality, turned out incorrect work.
But as far as improper billing etc. Sounds really bad.
Posted on 12/5/23 at 6:26 pm to DWaginHTown
Looks like sentencing up up coming, another trial it appears for collection of fee that his firm collected and this snake filed for bankruptcy.
Per the advocate
Per the advocate
Posted on 12/5/23 at 6:27 pm to DWaginHTown
Stealing $148 million dollars from us and will likely get minimal jail time. Absolutely disgusting. He should be forced to live in abject poverty the rest of his life
Posted on 12/6/23 at 7:09 am to AwgustaDawg
quote:
Health Care provides that defraud Medicare and Medicaid should be tossed in prison for LOOOOOONNNNNNGGGG sentences and non-violent drug offenders released. The damage done to society by the former is far greater than that done by the latter. The problem is there probably wouldn't be but about 5% of providers left in the country....the other 95% would be in jail
Home health is a huge scam in the hood. I know of a few specific cases in my area. The families live in huge two story houses and they have several luxury cars and suvs. They defrauded the govt for God knows how much. None of the family works, they have a ton of adult kids and they just bill the elderly but never do anything for the patients. They give a small kickback to patients family and dint show up for the work. Got caught, none of them did jail time and probably only paid back maybe 10% of what they stole. Probably less.
This post was edited on 12/6/23 at 7:10 am
Posted on 12/6/23 at 7:17 am to Rendevoustavern
quote:they aren’t new and there are Docs all over the country that have labs in their office
This is now illegal due to STARK laws.
Are is what you are referring a development specific to pain docs?
Posted on 12/6/23 at 8:00 am to tigerfoot
No, a physician cannot have a high complexity CLIA cert, which is anything that runs requires a tech to operate. They can own a lab but cannot bill Medicare for services.
They can charge a cash rate and be fine.
They can charge a cash rate and be fine.
Posted on 12/6/23 at 8:24 am to DWaginHTown
quote:
Brad Paul Schaeffer, 48, was a co-owner and CEO of MedComp Sciences in Zachary. Between January 2013 and August 2022, the company billed Medicare and Medicaid for the testing of 15 substances in all urine samples it received, regardless of the patient's medical history or what their medical providers had ordered, prosecutors said.
He must be friends with ...
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